2014 Open Enrollment Meetings 2014 Open Enrollment Meetings Health, Dental, Flexible Spending, Supplemental Life Insurance April 2014
Agenda Plan Overview / Comparison Medical Rates Precertification Reminder Dental Plan / Rates Medical and Dental Plan Enrollment Vision Plan / Rates Flexible Spending Wellness Healthgram Website Information Supplemental Life Insurance Enrollment Q&A
Schreiner Health Plan Schreiner continues to offer Faculty and Staff an excellent benefit package Our premiums and coverage are better than other comparable schools and also compared to local businesses of similar size Schreiner continues to share the burden of increased costs with employees; Schreiner cannot guarantee that we will always have a plan that is this rich Health Plan and rate adjustments were looked at from all sides Compared Employee cost to other tiers Looked at impact on employees at Schreiner’s entry wage Actuarial analysis
What’s New? Premium expenses will increase for both the employer and employee contributions (except for employee only contributions for medical). Premiums for the HDHP will not increase quite as much as the 70/30 plan. 70/30 plan deductibles and out-of-pocket maximums will increase. HDHP deductibles will increase, but out-of-pocket maximums remain the same. Primary PhysicianCare changed names in September to Healthgram. Our Life, AD&D, Supplemental Life insurance and our EAP is now provided at the same rates through The Principal. Flexible Spending Accounts will be have a carryover feature that allows up to $500 to be used in the following plan year. The HSA maximums will increase slightly again for this plan year.
Plan Comparison to Local and Peers SU KISD ActiveCare 3PRMC Gold Austin College Plan 2 Austin College Plan 3 Individual Deductible (in-Network) , Family Deductible1, ,0001,1001,500 Coinsurance70%80% 90%80% Single out of pocket max (includes deductible)5,0001,3006,3503,0505,950 Family out of pocket max12,500 deductible plus 1,000 per individual12,7006,10011,500 Physician Office Visit Zero Co-pay; Plan pays 70% after deductible $20 co-pay for primary, $30 co-pay for specialist $30 co-pay for primary, $30 co- pay for specialist $20 co-pay for primary, $40 co- pay for specialist $25 co-pay for primary, $50 co- pay for specialist ER Visit Plan pays 70% after deductible $150 co-pay, then plan pays 80% after deductible Plan pays 80% after deductible Monthly Premiums: Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Annual cost of premium for EE
70/30 Consumer Plan Effective 06/01/ /30 Consumer Plan Effective 06/01/2014 Co-Insurance/no change - SU pays 70%/Employee pays 30% after deductible Deductibles o Increase from $250 to $500 individual o Increase from $750 to $1,000 employee plus one or more Out-of-Pocket Maximum (includes deductible) o Increase from $3,750 to $5,000 individual o Increase from $7,750 to $12,500 Family Flexible Spending Accounts - Optional o Pre-tax funds, withheld via payroll to pay for medical or dependent care expenses Pharmacy o 90 day supply at either the retail location or the mail order
HDHP 2500 Effective 06/01/2014 Co-Insurance/no change - SU pays 90%/Employee pays 10% after deductible Deductibles o Increase from $2,000 to $2,500 individual o Increase from $4,000 to $5,000 Employee plus one or more o The increase to the individual deductible allows for imbedded deductibles for Employees with dependents Out-of-Pocket Maximum (includes deductible) o Remains at $5,000 Individual o Remains at $10,000 Employee plus one or more Health Savings Account o Pre-tax funds, withheld via payroll to pay for deductible and out-of-pocket Pharmacy o 90 day supply at either the retail location or the mail order
Plan Comparison 70/30 Consumer Plan In-Network Benefits HDHP In-Network Benefits Deductible Individual Family $500 $1,000 $2,500 $5,000 Out-of-Pocket Maximum Individual Family $5,000 $12,500 $5,000 $10,000 Primary Care Physician 70% after ded90% after ded Specialist Physician 70% after ded90% after ded Routine WellnessSchreiner pays 100% ded waived Outpatient Independent LabSchreiner pays 100% ded waived Emergency Care (facility only) 70% after ded90% after ded Urgent Care 70% after ded90% after ded Inpatient Hospital Services 70% after ded90% after ded Outpatient Hospital Services 70% after ded90% after ded Prescription Drug Benefit* (max 90 day supply) Generic Formulary Non-Formulary Contraceptives (generic only) 70% after ded 70% after ded 70% after ded Schreiner pays 100% 90% after ded 90% after ded 90% after ded Schreiner pays 100% Lifetime MaximumUnlimited
Medical Plan Pricing per Month 4-Tier Pricing 70/30 Current70/30 New HDHP 2000HDHP 2500 Employee Only$130 Employee + Spouse$215 $260 $215 $240 Employee +Child(ren)$205 $247 $205 $227 Employee + Family$305 $390 $305 $360
Flexible Spending Account The maximum pledge amount remains at $2,500 for a Health Flexible Spending Account (FSA) and $5,000 for dependent care FSA. The plan year will be from June 1, 2014 – May 31, Carryover of $500 will be allowed for use into the next plan year. Use-it-or- lose-it for any remaining balance exceeding $500 at the end of the Plan year. Please see Human Resources to complete your flex election form by May 16, Flexible Spending Accounts are a great way to pay for anticipated medical expenses with Pre-Tax dollars. Check your balances online at Current participants will have a grace period to use remaining funds until August 15, 2014
Health Savings Account The annual maximum contribution has increased to $3,300 for a Health Savings Account (HSA) for an individual and $6,550 for a family. If you are currently enrolled, you do not need to do anything at this time, unless you want to increase your monthly. Reminder: You can change your HSA contribution at anytime by notifying payroll of the increase or decrease, but always keep in mind the annual maximum allowed by the IRS. Your HSA Account is a great way to save for future medical expenses with Pre-Tax dollars.
Pre-certification Reminder
Pre-certification Example
Dental There will be no changes to dental benefits. There will be a slight increase in Premium. You can go to any dental provider, no network. Deductibles and $2,000 plan year maximums restart June 1, You will have one ID card for Medical, Dental, and Prescription. You may enroll in Dental coverage without enrolling in Medical coverage.
Dental Plan Pricing 4-Tier Pricing Current Employee ContributionNew Employee Contribution Employee Only$10.80 / month $11.34 / month Employee + Spouse$34.10 / month $35.82 / month Employee +Child(ren)$42.70 / month $44.84 / month Employee + Family$73.20 / month $76.86 / month Changes to monthly premiums only; no changes to plan provisions $2,000 plan year maximum per person on the plan, With additional $1,000 lifetime orthodontia benefit for covered dependents under 19 The Schreiner portion will continue to be $15 per month per employee regardless of coverage level
Online Open Enrollment
Healthgram Website Create/access your own account in order to: o Complete online enrollment o Access claims activity o View deductibles and out-of-pocket information o View prescriptions o Print EOB’s o Print claim forms o customer service o Wellness tools o And much more! If you have any questions or need technical support, please
Personal Health Record
Health Library
Wellness Resources
Vision VSP through Assurant Vision Care is our vision provider. In FY 2015 we will continue with the same premium and coverage. To find in-network providers please visit, Coverage TypeMonthly Employee Contribution Employee Only$6.04 Employee + Spouse$12.08 Employee + Child(ren)$11.09 Employee + Family$18.04
Basic Life and AD&D Coverage provided by Principal Financial Group (formerly The Hartford) Current Benefits Include: o Basic Life and Accidental Death and Dismemberment (AD&D) insurance is an plan that is 100% Employer paid. The plan covers eligible employees for One times your basic annual earnings to a maximum of $100,000 with a minimum of $25,000. o Upon termination of employment, life insurance may be converted to an individual policy.
Voluntary Life Coverage Coverage provided by Principal Financial Group (formerly The Hartford) Current Benefits Include: o Employee coverage - includes $10,000 increments to a maximum of $500,000, not to exceed 5 times annual earnings. o Spouse coverage - includes $5,000 increments up to a maximum of $100,000. o Employee must enroll in supplemental life and have 50% more coverage to allow dependents to be eligible for coverage. o Child coverage - includes $5,000 increments up to $10,000 and does not require medical evidence. Child coverage starts on day 1 and ends at age 26.
Voluntary Life Coverage During Annual Enrollment – you will now have the opportunity to update or increase Voluntary Life coverage for you and your dependents. Employees and Spouses are allowed a 1x increment increase without medical evidence this year as long as it does not exceed the guaranteed issue amount. Any increases over 1x increment or over the guarantee issue amount will require medical evidence. Guaranteed Issue Amounts at time of employment are: o $200,000 for Employee o $50,000 for Spouse o $10,000 for Children Upon termination of employment, Voluntary life insurance may either be converted or ported to an individual policy.
Voluntary Life and Accidental Coverage Rates Supplemental Life Rates Supplemental AD&D $0.02/$1,000 (for Employee and Dependents) Employee & Spouse <25 $0.059/$1, $0.28/$1, $0.059/$1, $0.489/$1, $0.059/$1, $0.681/$1, $0.084/$1, $1.27/$1, $0.117/$1, $2.068/$1, $0.174/$1,00075> $2.068/$1,000 Child: $0.19/ Per $1,000 Unit
Long Term Disability 60% of your monthly earnings to a maximum of $7,000 per month Minimum is the greater of $100 or 10% of monthly income loss 2 Year Own Occupation with Any Occupation after that Elimination Period is 90 days Benefit Duration to Social Security Normal Retirement Age
Discounts and Services Type How to Access Travel Assistance Will & Legal Document Center Group policy number: Identity Theft Kit Group policy number: Beneficiary Support Communications sent directly to the beneficiaries on how to access Employee Assistance Program
Discounts and Services Type How to Access Laser Vision Correction Hearing Aid Program Weight Loss Oral HealthCare Promo code: PR25FT Magazine Program
Reminder o Schreiner continues to provide a competitive benefit package o HRS will assist you through the open enrollment process o Want a sample check to see the impact of changes on your budget? HRS can provide this!QUESTIONS???