The InterMed Group Employee Benefit Summary Effective- 10/1/2016 Brian Scarborough ,

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Presentation transcript:

The InterMed Group Employee Benefit Summary Effective- 10/1/2016 Brian Scarborough ,

Health Insurance- United HealthCare Plan 1- Health Savings Account (HSA) Plan Deductible- $2,000 for Individuals/$4,000 for Families National PPO/No Primary Care Selection Required 100% Coinsurance Out of Pocket Max- $3,000 for Individuals/$6,000 for Families Higher Costs/Deductibles Out of Network Copays After Deductible- - $30 Primary Care/$60 Specialists - $75 Urgent Care/$350 ER - Pharmacy- $10/$35/$60

HSA Plan Continued Hospital Inpatient Copay- $500 Advanced Imaging Copay (CT, PET, MRI)- $300 Preventative Care- No Charge Monthly Costs (Pre-Tax Deduction): Employee Only- $50 Employee & Spouse- $ Employee & Child(ren)-$ Employee & Family-$ * HSA Accounts will be through Optum HealthBank.

Health Plan #2- Copay (Non-HSA) Deductible- $2,500 per person/$5,000 family max. National PPO/No Primary Care Selection Required 80% Coinsurance Out of Pocket Max- $6,000 per person/$12,000 family max. Higher Costs/Deductibles Out of Network No Deductible Copays (No Deductible)- - $30 Primary Care/$60 Specialists - $75 Urgent Care/$350 ER - Pharmacy- $10/$35/$60

Health Plan #2 Continued Hospital Inpatient- Deductible + 20% Coinsurance Outpatient Surgery- Deductible + 20% Coinsurance Advanced Imaging Copay- $200 (No Deductible) Preventative Care- No Charge Monthly Costs (Pre-Tax Deduction): Employee Only- $78.34 Employee & Spouse- $ Employee & Child(ren)-$ Employee & Family-$915.19

Health Plans Side by Side * After deductible has been satisfied. * After Calendar Year Deductible has been satisfied. Insurance CompanyUnited Healthcare Plan NameH.S.A.Non-H.S.A. NetworkChoice Plus AccessNationwide PPO Deductible (Individual/Family)$2,000 / $4,000$2,500 / $5,000 Coinsurance (Your Share)0%20% Max Out-of-pocket (Ind./Fam.)$3,000 / $6,000$6,000 / $12,000 Primary Care$30*$30 Specialist$60*$60 Urgent Care$75*$75 Emergency Room$350*$350 Prescriptions (Generic/Brand/Non-Preferred) $10/35/60*$10/35/60 MONTHLY RATES Employee Only$50.00$78.34 Employee+Spouse$480.81$ Employee+Children$443.02$ Family$828.47$915.19

Ancillary Benefits Guardian Life Insurance Company Dental- Two Plan Options Vision Voluntary Life Insurance Employees- $100,000 Guaranteed Issue Limit Spouse Coverage- $25,000 Guaranteed Issue Limit Child(ren) Coverage- $5,000/$10,000 GI Options

Dental Insurance- Low Plan Lower Coverage Out of Network v. High Plan Better Pricing Than Current Plan and High Plan Monthly Costs (Pre-Tax): Employee Only$22.92 Employee & Spouse$46.54 Employee & Child(ren)$57.22 Employee & Family$86.10

Dental Insurance- High Plan Better Coverage In Network, But Same Deductible Better Pricing than Current Policy Monthly Costs (Pre-Tax): Employee Only$36.93 Employee & Spouse$74.98 Employee & Child(ren)$91.06 Employee & Family$ Children Eligible to Age 26 on BOTH plans.

Dental Plans Side By Side Low PlanHigh Plan Annual Maximum$1,500 Deductible- In/Out of Network$50/$100*$50* Deductible Per Family3 per family Preventative Care- In/Out of Network100%/80%100% Basic Care- In/Out of Network80%/70%90%/80% Major Care- In/Out of Network50%/40%60%/50% Monthly Rates Employee Only$22.92$36.93 Employee+Spouse$46.54$74.98 Employee+Children$57.22$91.06 Family$86.10$ * Deductible waived for Preventative Care.

Vision Coverage Annual Eye Exam- $10 Copay (In Network) Annual Glasses Frames- $130 Benefit/20% off balance Annual Glasses Lenses Benefit- $25 Copay Annual Contact Lenses Allowance- $130 per person National VSP Network Lower Benefits Out of Network Dependents Eligible to Age 26 Monthly Cost: Employee Only$5.62 Employee & Spouse$9.46 Employee & Children$9.65 Employee & Family$15.27

Employee Life Coverage $100,000 Guaranteed Issue Limit Those with current higher limits will be grandfathered in. Higher Limits Available through Medical Underwriting. Rates are Age Based in 5 Year Age Bands. Accidental Death Benefit Included (Doubles Amount) Rates are Per Thousand and Coverage Available in $10k Increments. Premiums are not pre-tax. Rating Example- 40 year old electing $100,000 will pay $21.50/mo. Rate Breakdown By Coverage Amount on Paycor. Designate Beneficiaries on Paycor. Coverage IS Portable. Coverage Reductions at ages 65 (35%), 70 (60%), 75 (75%) and 80 (85%).

Spouse Life Coverage Guarantee Issue Amount is $25,000. Coverage Available in $5,000 increments. Accidental Death Included. Rates Based on Employee Age. Coverage IS Portable. Employee must elect coverage on themselves and Spouse coverage cannot exceed Employee Life amount. Higher Amounts Available by Medical Underwriting. Coverage Terminates at age 70.

Child(ren) Life Coverage Options of $5,000 or $10,000. Coverage Applies to ALL Children at 14 days old to age 26. Coverage IS Portable. Coverage Includes Accidental Death. Employee must elect EE coverage to purchase. Monthly Premium- $5,000- $0.915$10,000- $1.83

Final Notes Enrollment must be completed online through Paycor by Thursday (9/15) at 5pm. All Pre-Tax benefits are locked in for 12 months barring a “qualifying event” per the IRS. Ancillary lines require 25% participation to move forward. Important Websites- (United HealthCare; (Guardian).

HSA Contribution Limits $3,350 for Individuals; $6,750 for Families $3,400 for Individuals; $6,750 for Families $1,000 “Catch Up” provision for ages 55+- $1,000 (Individuals & Families). True for both 2016 and If you come off of the HSA onto the Copay plan you cannot make HSA contributions after 9/30. You can still use funds in your HSA accounts until depleted.

Questions/Contact Information Brian Scarborough Scarborough Insurance Office Cell