BENEFITS OVERVIEW FOR 2015 PRESENTED TO: PRESENTED BY: JAY N. SCOTT, CHC Senior Vice President Employee Benefits Practice Group Leader Associated Financial.

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Presentation transcript:

BENEFITS OVERVIEW FOR 2015 PRESENTED TO: PRESENTED BY: JAY N. SCOTT, CHC Senior Vice President Employee Benefits Practice Group Leader Associated Financial Group Employee Benefits. Insurance. HR Solutions.

Copyright 2012 by Associated Financial Group, LLC 1 Fond du Lac County/14/Misc/Benefits Overview.pptx 30 – 40 Hours/Week All Benefits (Health, Dental, Vision, Sick, Vacation, Fl Hol, Disability, Wis Retirement) Pay Full Time Health Insurance Rates Full Time (FT) 24 – 29 Hours/Week Some Benefits (Health, Dental, Vision, Sick, Vacation, Fl Hol, Wis Retirement) Pay Reg Part Time Health Insurance Rates Regular Part Time (RPT) 20 – 23 Hours/Week Vac, Sick Time, Fl Hol Benefits Only 46+ Hours/Pay Period = Wis Retirement Limited Part Time (LPT) 0 – 19 Hours/Week No Benefits (may be eligible for Wis Retirement depending on hours worked on an annual basis) Part Time (PT) ELIGIBILITY FOR INSURANCE

Copyright 2012 by Associated Financial Group, LLC 2015 HEALTH INSURANCE RATES (TBD) 2 Fond du Lac County/14/Misc/Benefits Overview.pptx 2014 rate Employer Share 2014 Employee Share 2014 FT/Single w/HRA and met goal % FT/Family w/ HRA and met goal % FT/Single w/ HRA No goal % FT/Family w/ HRA No goal % FT/Single no HRA % FT/Family no HRA % RPT/Single w/HRA w/goal RPT Single w/HRA RPT Single no HRA % 15% 18% RPT/Family w/HRA met goal % Rates may increase 0-3% from the 2014 rates listed below

Copyright 2012 by Associated Financial Group, LLC 2015 MEDICAL BENEFIT HIGHLIGHTS NO CHANGES CONTEMPLATED 3 In-Network Benefits Only (with Some Exceptions) Deductible Single Family $250 $500 Coinsurance90% Out-of-Pocket Max Single Family $850 $1,700 Office Visit CopayN/A Emergency Room Copay$100 Rx Drug Copays Retail (30 day supply) Mail* (90 day supply) $10 / $30 / $45 $20 / $60 / $90 *Incentive program still applies Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC HEALTH INSURANCE Eligibility immediately extended to anyone legally married Fitness Reimbursement for covered employees increasing from $100 to $200 for 2015 Patient Care program is being eliminated in 2015 Spouse also eligible for routine physical gift card program in 2015 through the Virtual Clinic Smart Choice MRI incentive reminder HRA goal “alternative course of action” reminder 4 Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC HearPO DISCOUNT PROGRAM 5 Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC HEALTH CARE COSTS 6 Fond du Lac County/15/Misc/Benefits Overview.pptx ☺ 3% lower than public sector norm ☺

Copyright 2012 by Associated Financial Group, LLC ARE WELLNESS AND HEALTH NAVIGATOR PROGRAMS WORKING? 7 Fond du Lac County/15/Misc/Benefits Overview.pptx ☺ Cost per patient 14% less than public sector norm ☺

Copyright 2012 by Associated Financial Group, LLC EMERGENCY ROOM VISITS DECLINING 8 Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC PHYSICIAN VISITS DECLINING 9 Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC MENTAL HEALTH VISITS DECLINING 10 Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC Employee Assistance Program Primary Medical Care FOND DU LAC COUNTY’S TOTAL POPULATION MANAGEMENT INTEGRATED HEALTH IMPROVEMENT MODEL 11 Fond du Lac County/15/Misc/Benefits Overview.pptx Patient Education (Consumerism) Rx Drugs Smart Prescribing Health Navigator Health Promotion and Wellness Virtual Clinic Medical Home 11

Copyright 2012 by Associated Financial Group, LLC TIPS FOR BEING A HEALTHWISE CONSUMER $Use the Virtual Clinic $Use EZ Care for immediate needs $Get your teeth cleaned $Get a vision exam $Use your medical plan’s routine care benefits $Participate in the county’s wellness programming $Participate in Health Navigator if applicable $Use generic drugs and pill splitting $Participate in FSA program (saves 30% on OOP expenses) 12 Fond du Lac County/15/Misc/Benefits Overview.pptx

Copyright 2012 by Associated Financial Group, LLC DENTAL INSURANCE 13 Fond du Lac County/15/Misc/Benefits Overview.pptx Monthly Premium Employee $ Employee + Spouse $ Employee + Child(ren) $ Employee + Spouse + Child(ren) $ Rates increasing by 5.5% Originally projected to be higher No change in Benefits Anthem Discount Program Open enrollment (some waiting periods apply)

Copyright 2012 by Associated Financial Group, LLC VISION INSURANCE 14 Fond du Lac County/15/Misc/Benefits Overview.pptx Materials Only Full Service Employee $ 7.35 $ Limited Family $ $ Family $ $ No change in Rates No change in Benefits LASIK coverage Open Enrollment

Copyright 2012 by Associated Financial Group, LLC LONG-TERM DISABILITY INSURANCE 15 Fond du Lac County/15/Misc/Benefits Overview.pptx NO OPEN ENROLLMENT If you don’t have coverage, but want to pick it up, you need to apply and complete an Evidence of Insurability form. No change in Rates No change in Benefits Only Full Time employees eligible

Copyright 2012 by Associated Financial Group, LLC OPEN ENROLLMENT INFO 16 Fond du Lac County/15/Misc/Benefits Overview.pptx All forms due October 31 st If electing new coverage, please also submit those enrollment forms Found at

Copyright 2012 by Associated Financial Group, LLC QUESTIONS? 17 Fond du Lac County/15/Misc/Benefits Overview.pptx