BRIEF PLAN OVERVIEW FOR JULY 1, 2018 – June 30, 2019

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Presentation transcript:

BRIEF PLAN OVERVIEW FOR JULY 1, 2018 – June 30, 2019

Terms To Know Copay: A fixed dollar amount you pay to the provider (doctor, lab, etc.) each time you receive a covered healthcare service. You pay this flat fee directly to the service provider at the time of your appointment. The provider then bills the Plan for the remainder of the service price.

Terms To Know Deductible: The deductible is a set amount that you are responsible to pay toward your medical care before the Plan contributes. (First Dollar) In some cases, certain services are excluded from the deductible requirement. For example, copay for office visit under the Basic and Premier plans even if the deductible has not yet been satisfied.

Terms To Know Deductible: Individual Deductible: Family Deductible: The amount one covered person must pay before the Plan begins to pay benefits for that person. Family Deductible: The amount that all covered family members must pay before the Plan begins to pay benefits for the family members.

Terms To Know Coinsurance: After you have satisfied your deductible, you are responsible to pay a percentage of your medical expenses. The percentage amount can vary depending on the type of service received, and whether you use an in or out of network provider. The Plan begins to pay for the remainder due for your covered health expenses. For example: the Premier Plan pays 80% in-network, then you pay 20%; the Basic Plus Plan pays 60% in-network, then you pay 40%

Terms To Know Out-of-Pocket Maximum: The maximum or total amount that you have to pay for your health needs during the plan year (July 1-June 30). The Plan pays 100% of any healthcare expenses you incur for covered services beyond this limit, for the rest of the plan year. Except when copays apply.

Terms To Know Preferred Provider (In-Network): A health care provider who has agreed to charge lower, pre-negotiated discounted fees for eligible covered services The list of Providers includes doctors, hospitals, labs, urgent care facilities, etc. YCT’s network is Blue Cross Blue Shield of Arizona Preferred Provider Organization (BCBSAZ PPO) Out-of-network providers are still covered, but usually at a higher cost to the member, and may require Pre-certification.

Benefit Options YCT offers different benefit options for your needs: Medical Flexible Spending Accounts Premier Plan Health Care Basic Plus Plan Dependent Care High Deductible Health Plan Dental Life Insurance Comprehensive Basic Preventative Voluntary Vision Short Term Disability

Medical Plan Options Basic Plus Plan: In Network Annual Deductible = $600 Single / $1,200 Family You must pay this amount out of your pocket, for covered medical expenses until the limit is reached per plan year In Network Coinsurance = 60% / 40% After the deductible is met you pay 40% of the bill toward covered medical expenses The Plan will pay the other 60% towards covered medical expenses Annual Maximum Out of Pocket Limit = $6,000 Single / $12,000 Family After you have met the limit, the Plan pays all costs for covered medical expenses for the rest of the plan benefit year with the exception on copays.

Medical Plan Options Premier Plan: In Network Annual Deductible = $350 Single/ $600 Family You must pay this amount out of your pocket toward eligible medical expenses In Network Coinsurance = 80% / 20% After the deductible is met you only pay 20% of the bill for covered expenses The Plan will pay the other 80% toward covered medical expenses In Network Annual Maximum Out of Pocket Limit = $3,000 Single / $6,000 Family (coinsurance only) After you have met the limit, the Plan pays all costs for covered medical expenses for the rest of the benefit plan year with the exception of copays.

Medical Plan Options High Deductible Health Plan: (HSA Eligible) In Network Annual Deductible = $2,500 Single / $5,000 Family You must pay this amount out of your pocket, for medical and prescription covered expenses until the limit is reached If you have family coverage, the total $5,000 Family Deductible must be reached. There is no in-network coinsurance under this Plan In Network Annual Maximum Out of Pocket Limit = same as deductible amounts After you have met the limit, the Plan pays all costs for covered medical and prescription expenses for the rest of the plan year

Medical Plan Options Health Savings Account (HSA) If you elect the HDHP Plan, you may also enroll into a HSA Health Savings Account (HSA) Benefits: Allows you to save pre-tax money in a savings account, which can lower your tax liabilities for the current tax year No “use-it-or-lose-it rule’. Any money in the HSA rolls over to future plan years, continuing to grow tax free You can use the HSA money to pay for qualified, eligible health care expenses, for you and your dependents, including deductibles, copays and coinsurance, with no taxes or tax penalties Your employer may also contribute funds into your H.S.A.

Medical Plan Options Health Savings Account (HSA) Maximum limit for Calendar year 2018 Single Coverage = $3,450 Family Coverage = $6,850 You will receive an H.S.A. Debit card Total H.S.A. contribution must include all monies contributed to the H.S.A. pre-tax or post tax, including employer contributions.

Dental Plan Options YCT offers 2 Dental Plans you may choose from: Comprehensive Preventative There are two coverage levels you may elect: Employee Only; or Employee + Family

Dental Plan Options Dental Plan Benefits Highlights and Comparisons Benefit Description Comprehensive Plan Preventative Annual Deductible (July 1 – June 30) $50 per person; $150 per family $0 Annual Maximum $1,500 $250 Preventative Services (subject to annual deductible maximum) 100% no deductible Basic Services (including fillings, extractions, oral surgery) 80% Not covered Major Services (including onlays, crowns, dentures) 50% Orthodontic Services (for children up to age 18 who have participated in the dental plan for 24 consecutive months) Lifetime Orthodontic Maximum (not subject to annual dental maximum) Not applicable

Vision Plan Options YCT offers 1 Vision Plan There are two coverage levels you may elect: Employee Only; or Employee + Family

Vision Plan Options Vision coverage can be elected if you waive medical and/or dental coverage. Any optometrist, ophthalmologist or optician may be seen Each person enrolled can be reimbursed up to $300 per plan year benefit for any eligible expenses that may include: Exams Lenses Frames Prescription sunglasses, and Contact lenses See the Plan Document for the listed excluded benefits

Flexible Spending Accounts Flexible Spending Account (FSA) Program Benefits Allows you to deduct pre-tax money from your paycheck up to the maximum allowed limits, lowering your taxable income for the year. You will receive a Flex debit card. Health Care – up to $2,500 to use towards expenses not covered by your medical, dental and vision care plans such as copays, deductibles and out of pocket expenses Dependent Care – up to $5,000 to use towards the cost of dependent day care services for eligible children and/or other qualifying dependents

Flexible Spending Accounts Flexible Spending Account (FSA) Program Rules: Traditional Flexible Spending – You may elect if you are enrolled in the Basic Plus or the Premier Plan: All money contributed to your FSA must be used to pay for eligible Medical, Dental, Vision and Prescription expenses incurred during that plan year only Limited Flexible Spending – You may elect if you are enrolled in the HDHP All money contributed to your limited FSA must be used to pay for eligible Dental and Vision expense ONLY.

Other Insurance Options Additional Insurance Short Term Disability Insurance Provided automatically to eligible employees Benefit varies depending on your Employer Life Insurance: Basic Life Insurance Automatically provided to all eligible employees Paid for by the employer Dependents also may be eligible for Dependent Basic Life Insurance Voluntary Life Insurance Optional additional coverage to supplement Basic Life Insurance Purchased by the employee For more Information, contact your HR Department

MORE Information on Summit Administration Services, Inc MORE Information on Summit Administration Services, Inc., the Prescription Drug Program, FSAs, the YCT Plan Document and more are available online at: www.yctrust.net or www.summit-inc.net