Transcript (HSA)? - Kyrene School District
Slide 1
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
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Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
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Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
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Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
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Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
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Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
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UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
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Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
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Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
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40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
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Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
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Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
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HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
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Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
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How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
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How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
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How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
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Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
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How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
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How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
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Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
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Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
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OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
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See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
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Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
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42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
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Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
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Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
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QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 2
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 3
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 4
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 5
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 6
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 7
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
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Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 8
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 9
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 10
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 11
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 12
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 13
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 14
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 15
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 16
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 17
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 18
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 19
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 20
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 21
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 22
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 23
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 24
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 25
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 26
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 27
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 28
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 29
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 30
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 31
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 32
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 33
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 34
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
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Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
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UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 35
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 36
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 37
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 38
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 39
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 40
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 41
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 42
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 43
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 44
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
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$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 45
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 46
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 47
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 48
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 49
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 50
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 51
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 52
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 2
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 3
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 4
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 5
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 6
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 7
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
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Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
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Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
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OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
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See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
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$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
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$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
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Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
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Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
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Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
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42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 8
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
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Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
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Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
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How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
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Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
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OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 9
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 10
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 11
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 12
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 13
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 14
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 15
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 16
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 17
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 18
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 19
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 20
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 21
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 22
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 23
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 24
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
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Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 25
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
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Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
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Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 26
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 27
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 28
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 29
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 30
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 31
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 32
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
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Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
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Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
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Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
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Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
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Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
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UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
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Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
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Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
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40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
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Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
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Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
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HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
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Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
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How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
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How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
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How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
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How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
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How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
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Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
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Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
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OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
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Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
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Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
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Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
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Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
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QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 33
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 34
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 35
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 36
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 37
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 38
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 39
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 40
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 41
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 42
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 43
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 44
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 45
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
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Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 46
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 47
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 48
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
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Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 49
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 50
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 51
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders
Slide 52
READY. SET. GROW HEALTHY.
Your 2012 UnitedHealthcare Plan Benefits
What We Will Cover Today
Medical Plan Options
• Standard PPO Plan
• Premium PPO Plan
• Health Savings Account Plan (HSA)
UHC Tools and Resources
2
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Changes Effective July 1st
• Chiropractic Benefit Maximum will
change from $500 individual max to 18
visits per person per plan year on all 3
medical plans
3
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Preventive Care
Health plans will now cover certain preventive services
without charging a deductible, copayment or coinsurance.
Must be received at a network facility
Services may vary based on age, gender and health status
Preventive services included are described at
www.uhcpreventivecare.com
4
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Medical Benefits at a Glance
Standard PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 20%
after deductible
Emergency room services
$150 copay then 20%
after deductible
$150 copay then 20%
after deductible
Inpatient hospital stay
$250 copay then 20%
after $500 deductible per
individual per plan year
$250 copay then 40%
after $750 individual
deductible per plan year
Out of Pocket Maximum
$3,000 individual per
plan year (Deductibles and
copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
5
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
STANDARD MEDICAL PLAN
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Standard Plan Annual Plan Cost – NO COST INCREASE!
$500 annual deductible, 80% paid by plan in-network Wellness Coverage – 100%, annual deductible
does not apply, in-network
Tier
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$4,992
=$10,536
=$8,340
=$12,528
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
6
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$0
$5,544
$3,348
$7,536
Your Medical Benefits at a Glance
Premium PPO Plan
Type of coverage
Network benefit
Non-network benefit
Physician’s office services
10%
40% after deductible
Specialist office visit
10%
40% after deductible
$25 copay then 40%
after deductible
Urgent care center services
$25 copay then 10%
Emergency room services
$150 copay then 10%
$150 copay then 10%
after deductible
Inpatient hospital stay
$250 copay then 10%
$250 copay then 40%
after $500 deductible
Out of Pocket Maximum
$2,000 per individual
per plan year (Deductibles
and copays do not apply)
$6,000 per individual
per plan year (Deductibles
and copays do not apply)
7
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Kyrene Employee Benefits
Kyrene School District pays an annual medical allowance to each benefits eligible
employee who chooses a KEBT medical plan.
July 1 the allowance will be $4992.00
Premium Plan (Buy-up Plan) – Annual Cost
No annual deductible, 90% paid by plan in-network
Wellness Coverage – 100% in-network
Tier Level
Employee Only
Employee + Spouse
Employee + Child(ren)
Employee + Family
Total Cost
=$6,180
=$13,044
=$10,320
=$15,516
Allowance
-$4,992 =
-$4,992 =
-$4,992 =
-$4,992 =
8
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Your Cost
$1,188
$8,052
$5,328
$10,524
Standard and Premium Plans
Pharmacy Costs
Lowest
Cost
Retail
Mail order
Tier 1
$10 Member Cost
1-Month Supply
$20 Member Cost
3-Month Supply
Tier 2
$30 Member Cost
1-Month Supply
$60 Member Cost
3-Month Supply
Tier 3
$60 Member Cost
1-Month Supply
$120 Member Cost
3-Month Supply
Highest
Cost
9
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
UnitedHealthcare
Health Savings Account (HSA)
Plan
10
Consumer-driven health
Factors affecting rising health care costs
50% of health care
costs driven by
behaviors
For every 100 employees:
• 64 are overweight or
obese: average health
costs 10-12% higher
Genetic
20%
Access
10%
Behavior
50%
Environment
20%
• 23 smoke: average health
costs 30-33% higher and
annual productivity
costs 60% higher
• 19 experience stress: average
health costs
46% higher
Source: Adapted from Department of Health
and Human Services, Centers for Disease
Control and Prevention
11
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Consumer-driven health
We need to encourage more informed healthcare
decisions
• People
are currently removed from the true
cost of health care
• Health care costs are skyrocketing
• There’s a need to save for future health
care costs
12
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Your Medical Benefits at a Glance
HSA Plan – Non-Embedded Plan*
Type of coverage
Physician’s office services
Network benefit
Non-network benefit
20% after deductible
40% after deductible
Specialist office visit
20% after deductible
40% after deductible
Urgent care center services
20% after deductible
Emergency room services
20% after deductible
20% after deductible
20% after $1,500 single
deductible, $3,000 family
deductible*
(Single deductible does
not apply for families)
40% after $2,500 single
deductible, $5,000 family
deductible
(Single deductible does
not apply for families)
$4,500 for single coverage
per plan year. $11,000 for
family coverage.*
(Deductible applys)
$6,000 for single coverage
per plan year. $27,000 for
family coverage.*
(Deductible applys)
Inpatient hospital stay
Out of Pocket Maximum
(Single max does not apply
to families)
13
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40% after deductible
The HSA Plan
And pharmacy coverage
You will pay the full cost of medications until deductible is met
After you meet deductible, you will pay 20% for covered medications
If you meet your Out of Pocket Maximum prescriptions are covered at
100%
Medications listed on 2012 Preventative Drug List are covered at 100%
Introducing the HSA Plan
Combines a high-deductible health plan
that allows you the option to open a health
savings account (HSA)
High-deductible
health Plan
100%
network
preventive
care
Optional
health
Annual
savings
deductible
account
(HSA)
Annual outof-pocket
protection
15
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Personal
support and
messages,
health
coaches
What is a health savings
account (HSA)?
You can open and fund the HSA to pay the
plan deductible and other qualified health
care costs – or you can let your account
grow.
HSA
It’s yours
even if you
switch jobs or
plans
Triple tax
savings
Pay for
today’s $$ or
save for
tomorrow’s
Use for
qualified
expenses not
covered by
the plan
HSAs are designed to help you save
and pay for your health care
16
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Use it for
retirement,
investing*
What you should know about
the HSA
An HSA is not health insurance
Used to pay/reimburse qualified expenses
Each covered individual can open an HSA
No “use it or lose it” requirement
HSA is owned by you
17
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
HSA eligibility requirements
You may be eligible to open an HSA if:
• You are not covered by any other non-high deductible health plan,
•
•
•
•
•
such as a spouse’s plan
You are not enrolled in Medicare
You do not receive health benefits under TRICARE
You have not received Veterans Administration (VA) benefits
within the past three months
You cannot be claimed as a dependent on another person’s tax
return
You cannot be covered by a health care FSA or HRA
18
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Annual HSA contribution limits
Annual contribution limits are set by the IRS
Annual
Contribution
Rules
2011: $3,050 for individuals & $6,150 for
families
2012: $3,100 for individuals & $6,250 for
families
Additional
Funding
Those 55 years of age or higher, but not
entitled to Medicare benefits, can fund an
additional $1,000/year “catch-up”
contribution!
Amount of
Funding
Contributions above the annual limit are
subject to income taxes and a 20%
penalty.
19
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How you can use the HSA
Medical plan
deductibles and
coinsurance
Medical,
pharmacy,
dental and
vision care and
services
Use HSA
dollars to pay
for qualified
medical
expenses for
your spouse or
dependents
Any money you take out of your HSA for
eligible medical expenses is federal income-tax free
20
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How you can use the HSA
Other qualified expenses
1
Coverage while
receiving
unemployment
benefits
4
2
Medicare
premiums and
out-of-pocket
expenses
COBRA
continuation
coverage
3
Eligible longterm care
21
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
HSA Payment Process
Present ID card to
network doctor
Doctor sends
claim to
UnitedHealthcare
Doctor bills you
for payment
1. You can use
your HSA to pay
UnitedHealthcare
applies network
discount and
notifies doctor of
amount you may
owe.
When you have
claim activity,
you will receive a
Health
Statement.
2. Or you can
choose to pay
another way (cash,
credit card) and
reimburse yourself
later
TIP: Use your FSA to help you pay qualified expenses
22
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Explanation of Benefits (EOBs)
You may notice some changes on
your EOBs beginning late 2011.
You will see more information on:
– Appeal rights
– Consumer assistance
programs
What’s more the EOB has been
designed for easier readability.
We encourage you to access your
EOBs online at myuhc.com.
23
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Helps You Save
1
2
3
4
The money Steve puts into his HSA is
federal income tax-deductible.
Any money Steve withdraws from his
HSA to pay for qualified medical
expenses is withdrawn federal income
tax-free.
Steve may earn interest on his account,
and it is not taxable.
The amount not spent during this year
carries over for use in future years.
24
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How Much Did Steve Save?
1
2
In 2012, Steve will deposit $6,250 into
his HSA, the maximum contribution for
family coverage.
Steve’s federal and state income
tax savings and FICA on his
contributions for the year are
$2,478.
Steve will withdraw $3,000 to pay for
qualified health care expenses for him
and his family.
Steve will not have to pay income
taxes on the $3,000 as long as he
uses it to pay for qualified
expenses.
Steve earns interest on his account.
Steve does not have to pay federal
income taxes on his interest.
Steve will carry over $3,250 HSA dollars
(contributions – expenses + account
earnings) into.
With a traditional plan, Steve
wouldn’t have this carryover option,
which helps him save for the future.
3
4
25
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Comparing an HSA with an FSA
HSA
Limited-Purpose FSA
• Owned by employee
• Owned by employer
• Funded by the employee
and employer
• Funded by the employee
• Funds automatically
rollover to next plan year
• All funds must be used
by the end of the plan
year or grace period
• Only health care
expenses are
reimbursable
• Only vision, dental &
dependent care are
reimbursable
• Qualified expenses
determined by IRS and
employer
• Qualified expenses
determined by IRS and
employer
• Automatic enrollment
• Must enroll each year
enrollment
26
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Common Questions
1
• Enroll during your Open Enrollment period
How do I enroll?
• Check your employer benefit information for
details
Can I take the funds in my HSA
with me if I leave the company?
Yes. Funds belong to you even if you leave
your job, change health plans or retire.
Can others contribute to my
HSA?
Yes. Anyone can contribute to your HSA.
Keep in mind that annual contribution limits
above what is allowed are subject to income
taxes and a penalty.
2
3
4
How do I access the funds in
my account?
• Use your HSA debit card
• Pay by check, cash or credit care and
reimburse yourself later from your HSA
27
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
OptumHealthSM Bank, Member FDIC
UnitedHealthcare’s health care bank of choice
• FDIC-insured so you know your money is
safe
• Dedicated to helping people save for health
care
• One of the nation’s leading HSA custodians
• Offers a Health Savings Account Debit
MasterCard®
Only OptumHealth
Bank offers the
convenience of
HSA banking
through
myuhc.com
Pay bills
Make deposits
Reimburse yourself
Track spending
• Account holders will receive Health Savings
News e-newsletter
28
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
See your tax savings
And more
Choose the Right Mix of Fees and
Interest
Understand the rates, fees and features for each account type:
Health eAccess
Health eSaver
Monthly
Maintenance Fee
$0 if balance exceeds $500
$1 if balance is $1-$499.99
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Balance Required
to Obtain APY
Annual Percentage Yield (APY)
Annual Percentage Yield (APY)
Health eInvestor
$0 if balance exceeds $5,000
$3 if balance is $1-$4,999.99
Annual Percentage Yield (APY)
$0-$499.99
0.00%
$500-$999.99
0.00%
$1,000-1,999.99
0.00%
$2,000-$4,999.99
0.00%
$5,000-$14,999.99
0.00%
$15,000+
0.00%
Investment
Threshold
$2,000
$2,000
$500
Monthly Investment
Fee
$3
$0
$2.50
Variable based on balance
Variable based on balance
Investments are not FDIC-Insured, are not guaranteed, and may
lose value.
29
How the HSA Plan Works
30
How the HSA Plan Works
*From www.healthcarelane.com
31
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
How the HSA Plan Works
Chris chooses the HSA Plan for himself
because:
• No cost monthly premiums
• His employer is contributing $1,008
• Chance to use HSA to save for future
expenses
Here is what Chris’s plan looks like:
Employer deposits $1,008 in HSA
Chris deposits $1,000 in HSA
$1,500
Annual
deductible
*From www.healthcarelane.com
80%/20%
network
coinsurance
100%
network
coverage
$4,500
Out-of-pocket
maximum
Cheryl is a fictitious person used to illustrate UnitedHealthcare products.
32
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How the HSA Plan Works
1 preventive exam per member
$400
1 visit to urgent care
$200
1 doctor visits
$100
2 prescriptions
$100
Non-preventive total
$400
Paid 100% by plan
And Chris still has
$1,608 in his HSA!
Chris uses HSA to pay
HSA paid total
Chris paid
$1,608 in HSA
$2,008
$1,500
Annual
deductible
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
33
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$400
$400
How the HSA Plan Works
Jane chooses the HSA Plan because:
• No monthly premiums
• Typically has few health expenses
• Ability to open and save with an HSA
• Tax savings
Here is what Jane’s plan looks like:
District funds HSA $1,008 in HSA
80%/20%
network
coinsurance
$1,500
Annual
deductible
100%
network
coverage
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
34
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Chris is a fictitious person used to illustrate UnitedHealthcare products.
How the HSA Plan Works
All other expenses are covered
100% for the rest of the year
Emergency surgery
$100,000
6 Doctor visits
$1,000
24 Prescriptions
$2,008
Total actual cost
Insurance pays (80%)
Jane to pay
(20%)
But she pays only $3,492
to get to her $4,500 maximum.
$103,008
Jane pays
District deposits $1,008 in HSA
Reaches deductible
Jane uses HSA to meet a portion
of her deductible
Remaining bill
$102,000
$1,500
Annual
deductible
80%/20%
$4,500
Out-of-pocket
maximum
*From www.healthcarelane.com
35
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
$3,492
100%
Jane compares plans…
Premium PPO
Standard PPO
HSA
District Funded HSA Pays
$0
$0
<$1,008>
Member Deductible
$0
$500
$1,500
Out of Pocket Maximum
$2,000
$3,000
$4,500
Copays
$1,000
$1,000
$0
Premium
$1,188
$0
$0
$4,188
$4,500
$3,492
Member costs
Total Member Pays
36
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Wellness Tools
37
myuhc.com
Find network
doctors/hospitals
Estimate costs
Track claims status
Build a health
improvement program
Keep a Personal
Health Record
Get health product
discounts
Review plan details
38
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Large National Network
More than:
660,000
doctors
1,000
5,100
hospitals
60,000
convenience pharmacies
care clinics
And world-wide
emergency care coverage
39
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Our Large National Network
Your doctor is likely already in our network.
Available to
Includes
98% 2
of Americans
More than
3
out of
providers
Includes
1,000 95,000
convenience
care clinics
Specialists designated
for their quality and
cost efficiency based
on national standards
40
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Promoting Quality & Affordable
Health Care
The UnitedHealth Premium® program evaluates
doctors for quality and cost efficiency to help you
choose a doctor with confidence
Doctors who meet both quality and cost-efficiency
guidelines receive two stars, and those who meet
quality receive one star
Quality Care
+
UnitedHealthcare
awards one star to
physicians who meet
national standards for
quality care.
Cost-efficient Care
UnitedHealthcare
awards a second star to
physicians who meet
local area benchmarks
for cost-efficient use of
resources in delivering
health care.
=
UnitedHealth Premium
Two-Star Physicians
Two-star physicians have been
recognized for providing
quality and cost-efficient care
to their patients. They meet or
exceed nationally recognized
guidelines, and they’re likely to
recommend the right tests and
treatments for a variety of
conditions.
41
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Treatment Cost Estimator
• Designed to calculate and
compares cost differences for
treatments between providers,
locations and facility types,
including both plan and member
expenses for each treatment
Includes treatment costs for:
~ 116 diseases/conditions
~ 500+ individual services
~ 90 surgeries/procedures
~ 3,000+ medications
SOURCE: UnitedHealthcare service data, April 2010
42
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
42
Care24 Nurseline and EAP
Connect with a registered nurse and highly
experienced counselors
Get help with legal, financial and emotional needs
Prepare yourself before you seek a doctor’s care
Access recorded messages on health topics
Communicate in live, one-to-one Nurse Chats
at myuhc.com
Care24 1-866-271-7340
43
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Healthy Pregnancy Program
Get support through every stage of pregnancy
Nurses available, toll-free, 24/7
Personalized pregnancy assessment
Educational materials and resources
No Additional Cost Gifts and Savings
–Your Journey Through Pregnancy, a book
that will help you learn more about your
nine-month journey..
–A booklet from Johnson & Johnson:
What’s Next?: The magic unfolding
of the first days of life.
44
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Get Health4Me and DocGPS®
App Today!
Find network doctors with our
new mobile phone app
• Uses Google® Maps
• Search based on your location
• Download for iPhone®,
BlackBerry® and Droid phones®
Google Android is a trademark of Google, Inc.
iPhone is a registered trademark of Apple, Inc.
BlackBerry is a registered trademark of Research in Motion Limited
Droid is a registered trademark of Lucasfilms Ltd.
45
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
Custom Plan Cost Estimator
(PCE)
What is it?
It’s an easy-to-use, personalized health
plan comparison tool that helps
employees select the right plan based on
their personal health needs and financial
requirements.
Designed for use during open
enrollment, during a life status change,
or for new hires
Pre-loaded with benefit parameters
Integrated HSA/FSA calculators
Explore Health Care Lane Today!
A fun and interactive way to learn about health insurance
healthcarelane.com/kyrene
47
Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
QUESTIONS
Current WOW Wellness Initiatives
Funded by Wellness Budget Provided by UHC
Mobile On-site Mammography (MOM) Fall & Spring
Fall Health Expo – Diabetes Prevention & Control & Let’s Move in Kyrene
WOW Spring Programs Kick-Off – Diabetes Screenings
WOW Biggest Loser Competition – January – March, 12 News Feature
WOW Healthy U
WOW – Walk or Run = Win
WOW Health Club Participation & Weight Loss Program Drawings
Leadership & Innovation Award, Wellness Council of Arizona
2012 AZ Healthiest Employer – Phoenix Business Journal
Voluntary Benefit Plans
Vision – Avesis, No rate changes for vision plan. Many retail
providers, including Nationwide, Eye Masters and COSTCO
Dental – Total Dental Administrators No rate increases on
Prepaid plan or PPO dental
Short-term Disability –Assurant, same premium rates great
premium rates, for medical leaves of absence which exceed 8
days to 6 months
Long-term Disability through ASRS, Sedgwick CMS, for
disabilities greater than 6 months, employees over 20 hours are
automatically enrolled for this plan.
Voluntary Benefit Plans
Life Insurance – Standard Life, No premium rate increases
Employer Paid Life Insurance Policy $50,000
Flexible Spending - BASIC, Pre-tax Savings plans
$2,500 annually Medical Expenses
(reduced amount allowed due to health reform required changes)
$5,000 annually for Dependent Care Expenses; such as
daycare or eldercare
If you are enrolling in the new medical plan Health Savings Account, please
be aware that you will not be able to use a flex medical for most expenses.
403/457b Optional retirement savings, provider ING Roth options now
available, hardship transactions and other transactions from ING accounts.
Open Enrollment Reminders
Online Open enrollment April 16 – May 4, 2012 by 4:30 pm
All benefits eligible employees must re-enroll, no plans roll over
Consider Standard PPO Medical Plan or the Health Savings Account
(HSA)
If enrolling in the Health Savings Account, you will be required to open a
bank account with OptumHealth Bank
Remember some plans require hardcopy forms in addition to the online
enrollment, such as voluntary life and short term disability
Please read all benefits communications and Kyrene email reminders