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Washington College Benefits Overview Always refer to your plan documents/booklets for detailed information on these benefits May 2013.

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Presentation on theme: "Washington College Benefits Overview Always refer to your plan documents/booklets for detailed information on these benefits May 2013."— Presentation transcript:

1 Washington College Benefits Overview Always refer to your plan documents/booklets for detailed information on these benefits May 2013

2 Agenda Consumer Driven Health Plan (CDHP) - Choice Plus HDHP (High Deductible Health Plan) with HSA (Health Savings Account) – NEW PLAN – Plan Overview Flexible Spending Account (FSA)  Innovative Health Services Limited Use Healthcare FSA (HDHP with HSA Plan) – NEW PLAN Dependent Care FSA Online Enrollment Portal – HRconnection 2

3 3 UnitedHealthcare Medical Plans

4 Which Plan is Right for Me? Are my current healthcare providers in the United Healthcare network? Did I visit any healthcare providers outside of the United Healthcare network in the past plan year? Do I plan on visiting any healthcare providers outside of the United Healthcare network in the upcoming plan year? Do I have a desire to minimize my Out-of-Pocket expenses and payroll deductions? 4

5 Benefit Plans Comparison Choice Plus HDHP with HSAChoiceChoice Plus Deductible $1,250 Individual (WC funds $500) $2,500 Family (WC funds $1,000) $250 Individual $500 Family $250 Individual $500 Family Out-of-Pocket Maximum $2,500 Individual $5,000 Family $250 Individual $500 Family $250 Individual $500 Family Co-Insurance 80%100% Physician Office Visits- Sickness & Injury 80% After Deductible $25 PCP / $25 Specialist copay $25 PCP / $25 Specialist copay Preventive Service 100% Inpatient Hospitalization 80% After Deductible100% After Deductible Emergency Room 80% After Deductible$75 (waived if admitted) Urgent Care Center 80% After Deductible$50 Physical, Speech, & Occupational Therapy 80% After Deductible$25 copay Prescription Drugs $10 tier 1 / $35 tier 2 / $60 tier 3 - After Deductible $10 tier 1 / $35 tier 2 / $60 tier 3 $10 tier 1 / $35 tier 2 / $60 tier 3 Out-of-Network Option Yes (includes deductible, coinsurance and possibility of balance bills None Yes (includes deductible, coinsurance and possibility of balance bills) 5

6 Consumer Driven Health Plan (CDHP) Choice Plus High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) 6

7 Consumer Driven Health Michael Consumer Driven HealthChoiceChoice Plus Annual Payroll Contribution $208$835$1,674 Employee Contribution to the Fund $750N/A Washington College Contribution to the Fund $500N/A Expenses 4 Office Visits$400 $100 1 Routine Physical$150$0 2 Prescriptions – tier 1$80 $20 Subtotal$630$480$120 Annual Out-of-Pocket Costs (Excluding payroll contributions) $0$120 Annual Out-of-Pocket Costs (Including payroll Contributions) $208$1,005$1,844 Remaining 'HSA Funds $770 7

8 How Your Plan Works 1. Your deductible 2. Your coverage 3. Your out-of-pocket maximum 8

9 How Your Plan Works 1. Your deductible — You will pay out of pocket until you reach the deductible. 2. Your coverage — Your plan pays a percentage of your expenses. 3. Your out-of-pocket maximum — You are protected from major expenses. 1. Your deductible 2. Your coverage Your plan pays % You pay % + COINSURANCE 3. Your out-of-pocket maximum You are protected When you reach your out-of-pocket maximum, the plan pays 100%. Preventive care is covered 100% in the network. You choose to pay out of your pocket OR with your HSA 9

10 The Plan in Action This is Mary. The health plan gives her: Lower monthly premiums An HSA contribution from her employer Ability to choose any doctor Unspent HSA dollars can roll over Possibly no out-of-pocket costs 10

11 The Plan in Action A snapshot of Mary’s plan: 1. Deductible $1,250 Preventive care is covered 100% in the network. Mary’s annual deductible is $1,250. 1. Her employer is funding $500 in the HSA. Mary contributes $750 to the HSA. Preventive care is covered 100% in network. Mary is responsible for her deductible. Mary chooses to pay out of her pocket OR with her HSA Example assumes services are received in network. 11

12 The Plan in Action A snapshot of Mary’s plan: 2. Coverage 80 / 20 Mary’s plan pays 80% Mary pays 20% + COINSURANCE Preventive care is covered 100% in the network. After her deductible is met, Mary’s coverage is 80% / 20%. 2. Mary’s plan will pay 80%. Mary will pay 20%. This is called coinsurance. 1. Deductible $1,250 Mary chooses to pay out of her pocket OR with her HSA Example assumes services are received in network. 12

13 The Plan in Action A snapshot of Mary’s plan: 2. Coverage 80 / 20 Mary’s plan pays 80% Mary pays 20% + COINSURANCE 3. Out-of-pocket Maximum $2,500 Mary is protected When Mary reaches her out-of-pocket maximum, her plan pays 100%. Preventive care is covered 100% in the network. Mary’s out-of-pocket maximum amount is $2,500. 3. When Mary reaches her out-of-pocket maximum, the plan pays 100%. Mary is protected. 1. Deductible $1,250 Mary chooses to pay out of her pocket OR with her HSA Example assumes services are received in network. 13

14 Mary’s Plan in Action Mary has $500 in preventive care services. 2. Coverage 80 / 20 Mary’s plan pays 80% Mary pays 20% + COINSURANCE 3. Out-of-pocket Maximum $2,500 Mary is protected When Mary reaches her out-of-pocket maximum, her plan pays 100%. $500 in preventive care fees are covered 100% = Mary pays $0. These are covered 100% by the plan. 1. Deductible $1,250 Mary chooses to pay out of her pocket OR with her HSA Example assumes services are received in network. 14

15 Mary’s Plan in Action Mary has $300 in physician and other care fees. 1. Deductible $1,250 Mary pays $0 + 2. Coverage 80 / 20 Mary’s plan pays 80% Mary pays 20% + COINSURANCE 3. Out-of-pocket Maximum $2,500 Mary is protected When Mary reaches her out-of-pocket maximum, her plan pays 100%. $500 in preventive care fees are covered 100% = Mary pays $0. Mary decides to use her HSA to pay the $300. HSA pays $300 Mary pays $0 out of pocket and has $950 left in her HSA. HSA pays$300 $950 left in HSA Example assumes services are received in network. 15

16 Mary’s Plan in Action 1. Deductible $1,250 Employer funds $500 Unused HSA dollars will roll over for the next plan year: Mary’s $950 rolls over to help for next year. This means more HSA money for future health expenses. Mary will have less to pay to meet her deductible for the next plan year. HSA balance $1,450 Example assumes services are received in network. Mary now has $1,450 in her HSA. 16

17 WHAT IS A HEALTH SAVINGS ACCOUNT (HSA)? 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 Use it for retirement, investing 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. HSAs are designed to help you save and pay for your health care *Health Savings Account can only be established in conjunction with the Consumer Driven Health plan offering 17

18 Opportunity to open a bank account called a health savings account (HSA) Coverage for non-network care is allowed, however it may be covered at a lower benefit level. See any network doctor, including specialists, without referrals No need to choose a primary care physician 100 percent preventive care coverage in our network No copayments, coinsurance does apply No need to submit claims for network care Care management if you require hospital stay or surgery – Nurse would assist in moving care along Prior-authorization from your in network provider may be needed for certain services UnitedHealthcare Health Savings Account (HSA) Combines a high- deductible health plan (HDHP) that allows you the option to open a health savings account (HSA) 18

19 myuhc.com 19 Find network doctors/hospitals Estimate costs Track claims status Build a health improvement program Keep a Personal Health Record Get health product discounts 19

20 20 myClaims Manager Understand and Track your healthcare claims User-friendly claim service descriptions Colorful visuals illustrate how each claim was processed, including what the member owes „„ Identify claims to watch or follow up on; mark claims already paid; add personalized notes Make informed health care financial decisions Seamless access to Health Statements and Explanation of Benefits

21 myHealthcare Cost Estimator Know the 4 Ps when shopping for health care. myHealthcare Cost Estimator provides you with a wealth of information before you go to the doctor. Now, searching for personalized health care information is as easy as any online shopping experience. 1. PROCEDURE Learn more about a procedure and compare treatment options. 2. PROVIDER Select a quality provider for a procedure. 3. PRICE Quickly estimate out-of-pocket costs for specific procedures. 4. PLACE Locate providers based on geographic search criteria, view maps and print directions. 21

22 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 HSA eligibility requirements 22

23 WHAT YOU SHOULD KNOW ABOUT THE HSA An HSA is not health insurance Used to pay/reimburse qualified expenses No “use it or lose it” requirement HSA is owned by you Each covered individual can open an HSA 23

24 ANNUAL HSA CONTRIBUTION LIMITS Amount of Funding Contributions above the annual limit are subject to income taxes and a 20% penalty. IRS Annual Contribution Rules 2013: $3,250 for individuals & $6,450 for individual plus one or more 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! 24

25 HOW THE HSA WORKS Doctor sends claim to UHC UHC applies network discount and notifies doctor of amount you may owe HSA Payment Process Present UHC Consumer Driven Health plan ID card to network doctor Doctor bills you for payment You can use your HSA to pay Or you can choose to pay another way (cash, credit card) and reimburse yourself later When you have claim activity, you will receive an Explanation of Benefits 25

26 USING HSA WITH AN FSA You can have both an HSA and a FSA These two accounts allow you to reduce the majority of your annual out-of-pocket health care expenses FSA, in conjunction with HSA, can only be used for qualified vision dental and dependent care expenses 26

27 COMPARING AN HSA WITH AN FSA Owned by employer Funded by the employee All funds must be used by the end of the plan year or grace period Only vision, dental & dependent care are reimbursable Qualified expenses determined by IRS Must enroll each year FSA Owned by employee Funded by the employee and employer Funds automatically rollover to next plan year Only health care expenses are reimbursable Qualified expenses determined by IRS Automatic enrollment HSA 27

28 It is the employee’s responsibility to keep up with their receipts, banking accounts, etc. The employee is responsible for how they spend their HSA money within the IRS guidelines. Must report all HSA spending on taxes No use it or lose it -- it's the employee's money. Prescriptions apply towards deductible. Once deductible is met, co-pays will apply. If employee funds a FSA in conjunction with the HSA, the employee is responsible for ensuring that the FSA funds are only used for dental and vision expenses – NO Medical expenses Any FSA funds used for medical expenses will result in a denied reimbursement THINGS TO REMEMBER 28

29 Your Bank OptumHealth Bank SM, Member FDIC UnitedHealthcare’s preferred health care bank The national leader in HSA banking Offers the convenience of banking through myuhc.com ® 29

30 30

31 In addition, you get: The Health Savings Account Debit MasterCard® to make easy payments Online bill payment Help tracking your HSA deposits for the most tax savings Health Savings News, an e-newsletter for health care saving and spending tips Need Another Debit Card? You can add another cardholder to your account when you enroll online. Have this information ready for every additional cardholder: Name of cardholder Social Security number Date of birth Need assistance? Call Customer Care at 1-800-791-9361 31

32 Choose the right mix of fees and interest Understand the rates, fees and features for each account type: Investments are not FDIC-Insured, are not guaranteed, and may lose value. Health eAccessHealth eSaverHealth eInvestor Monthly Maintenance Fee Balance Required to Obtain APY Investment Threshold Monthly Investment Fee $0-$499.99 $500-$999.99 $1,000-1,999.99 $2,000-$4,999.99 $15,000+ $5,000-$14,999.99 0.00% Annual Percentage Yield (APY) $2,000 $500 $3 $0$2.50 $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 $0 if balance exceeds $5,000 $3 if balance is $1-$4,999.99 *Interest rates are subject to change. 0.05% 0.60% 0.50% 0.30% 0.05% 0.30% 0.60% 0.50% 1.00% 0.05% 32

33 New Online Enrollment Portal All Employees MUST Go Online to Enroll or Waive 2013 Benefits 33 HRconnection Portal

34 EMPLOYEE LOGIN When you type in www.hrconnection.com, you will arrive at this screen. Your username will be emailed to you from NOREPLY@HRCONNECTION.com. You will need to follow the instructions in that email on how to reset your password. 34

35 YOUR HRconnection HOME PAGE Quickly get to recommended links and frequently used items Place your mouse over each of the menu categories for a description of the information stored within each category. View a message posted by Washington College Change your username or password, or log out Fast access to open enrollment elections 35

36 The HRconnection Online Enrollment Portal will be open from Monday, May 13 th through Midnight on Monday, May 27 th. 36


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