1. Salt Lake Community College
Open Enrollment

2. April 25th through May 31st OPEN ENROLLMENT
If you do not make a vision, medical, and/or dental election prior to May 31st, you and any enrolled dependents will remain in the same plan/network for the plan year.
Open Enrollment elections cannot be made after MAY 31, 2017.
For 2014/2015 the PVC network will be the default plan SLCC is still working out all of the details on how they want to accomplish this. If they roll out the online enrollment system to their employees, then Regence will move everyone that is currently in the PAR network to the PVC network and employees will need to go online and make an election if they want to move back to the PAR network.
If they decide not to roll out the online enrollment sytem to their employees, we will probably leave employees in the network they are in today, but they will need to make an physical election, mostly likely via an app, to remain in the PAR network.
Focal Point members will remain in the PFP network unless they want to make a change at open enrollment.

3. Employee Options April 25th – May 31st
Enroll or make changes to your health insurance
Add or remove dependents from your vision insurance
Enroll in an Health Savings Account (HSA) - new enrollees only
Reenroll in the Flexible Spending Account (FSA)
Enroll or increase coverage for Voluntary Life

4. WHAT’S NEW FOR
Changes to the vision plan can now be done online
Telehealth will be offered starting July 1
Emergency Room visit change
Was $150 copay with deductible waived
Starting July 1, it will change to 20% after deductible
Out-of-Pocket maximum change on Traditional Plan only
Was $2,900 (single)/$5,800 (family)
Starting July 1, it will change to $3,200 (single)/$6,500 (family)

5. Open Labs May 3rd 2:00 – 4:00 May 4th 10:00 – 12:00
Redwood Library Room 266
May 4th 10:00 – 12:00

6. VRx

7. Mail Order Mail order located in Salt Lake City
11/14/2017
Mail Order
Mail order located in Salt Lake City
-Name has changed to Magellan Pharmacy (previously VRx byMail)
Available on our website and by phone
/ Fax
7 a.m. to 7 p.m. MST
VRx Confidential

8. Specialty Pharmacy Specialty pharmacy located in Salt Lake City
11/14/2017
Specialty Pharmacy
Specialty pharmacy located in Salt Lake City
-Now called Magellan Specialty Pharmacy (previously VRx Specialty Pharmacy)
Available on our website and by phone
7 a.m. to 7 p.m. MST
VRx Confidential

9. Prescription Drug Plan Design
TRADITIONAL PLAN
RETAIL 30-DAYS
RETAIL 90-DAYS 
MAIL ORDER
Tier 1 - Generic $7
Tier 2 - Formulary Brand
25% ($150 max) *
25% ($300 max)
Tier 3 - Non-Formulary Brand
30% ($175 max) *
30% ($ max)
SPECIALTY
Tier 1 – Specialty
10% ($250 max)
Tier 2 – Specialty
Tier 3 – Specialty
15% ($350 max)
Tier 4 – Specialty
Excluded
RX DEDUCTIBLE
Individual/Family
$100 / $300
RX MAXIMUM OUT OF POCKET
$2,000 / $6,000
* After deductible met.
We understand that Consider changing this if retail is not covered.

10. VRx is here to help! Contact a VRx Member Advocate with ANY questions!
Monday through Friday 7am- 7pm MST at
You can also visit our website at

11. Health Savings & Flexible Spending Accounts Administered by National Benefit Services, LLC
Salt Lake City, Utah

12. Health Savings Accounts: Increase Your Spending Power
Healthcare HSA
Tax Savings on ALL expenses related to medical, dental, & vision care
Contribute pre-tax money
Funds accrues tax-free
Withdraw funds tax-free (if used for eligible medical expenses)
Funds can be used as they are deposited
Funds rollover each year so you can use your HSA to save tax-free money for retirement
Flexibility in funding
Can enroll whenever you become eligible

13. Who is Eligible for an HSA?
An employee who is:
Covered by a HDHP
18 years or older
Not enrolled in Medicare
Not covered under other health insurance*
Not another person’s tax dependent
* Other health insurance does not include specific disease or illness insurance, accident, disability dental care, vision care and long-term care insurance.

14. Whose expenses can your HSA cover?
You and your spouse
Any dependent claimed or eligible to be claimed on your tax return (defined by IRS Section 152)
Dependents are:
For health insurance a dependent can be covered to age 26 regardless of status.
HSA funds cannot be used for medical expenses incurred by a child who is not eligible to be claimed as a dependent on your tax return
Those dependents can still be covered on your HDHP

15. Employer Contribution 2017-2018
The College will contribute $50 per paycheck into each employee’s HSA
The first contribution will be on the July 22nd pay check
$1,200 over the fiscal year
Future SLCC contributions will be evaluated on a year to year basis

16. Flexible Spending: Increase your spending power
Healthcare FSA
Tax Savings on ALL expenses related to medical, dental, & vision care
Maximum contribution limit is $2600
Funds loaded to your NBS MasterCard on the 1st day of the plan year (plus manual reimbursement options are available too)
Dependent Care FSA
Tax savings on your day care/child care expenses
Maximum contribution limit is $5000
Continual reimbursement is available plus many other convenient reimbursement options

17. Why Participate Save Taxes on EVERY paycheck!
No FSA
With FSA
Gross Pay
$1,200
Contribution —
$200
Taxable Income
$1,000
Taxes
$261.41
$201.36
Net Pay
$938.59
$798.64
Preschool Expense
Spendable Income
$738.59
Annual Savings
$1,441
Save Taxes on EVERY paycheck!
Example:
An employee, Susan, has one child attending preschool.
She pays her pre-school provider $400/month.
She is paid twice per month so she pays her preschool provider $200 every paycheck.

18. FSA & HSA Expenses Qualified Not Considered “Qualified”
Doctor and hospital visits
Medical equipment
Chiropractic Care
Dental care
Vision care
Medications
The penalty for using HSA funds for unqualified expenses is 20% + taxes. Keep all itemized receipts in case of an IRS audit
Not Considered “Qualified”
Insurance premiums (other than the Medicare)
Over-the-counter drugs without a prescription (insulin is an exception)
Cosmetic procedures
Expenses covered by another insurance plan
General health items

19. 2017 Contribution Limits HSA FSA $3,400 for individual coverage
$6,750 for family coverage
$1,000 catch-up contributions (age 55 or older)
Employer & employee contribution
FSA
$2,600 medical
$5,000 dependent day care

20. HSA vs FSA HSA FSA Funds are available as they are deposited
Must be covered by HDHP
No adjudication required
No forfeiture
FSA
Funds available on July 1st
Medical coverage does not matter
Adjudication required on all expenses
Unused funds are forfeited at plan year end.

21. Administration fee per paycheck
FSA or Dependent Day Care FSA - $1.50
HSA - $1.43
If you already have a debit card from last year:
FSA funds will be loaded onto the card on July 1st.
HSA funds will be available as deposited

22. NBS Mobile App
With the NBS mobile app, you can easily manage your benefits on-the-go!
View your account balances
See claim and reimbursement history
Submit claims
Attach documentation with your device’s camera
Set up account notifications and alerts
Report benefit card lost/stolen
Order new benefit cards
Quick contact to NBS
Available at the iTunes Store and Google Play Store.

23. NBS Online Enrollment Portal

24. Medical & Dental Benefits
Open Enrollment

25. DENTAL RATES 2017-2018 Per Pay Check
2016/17
2017/18
Employee
$2.25
Two-Party
$3.75
Family
$5.95
No change to dental rates

26. MEDICAL RATES 2017-2018 Per Pay Period
PAR
TRADITIONAL PLAN
QHDHP
Increase from 2016
2017/18
Employee
+$5.00
$58.00
+$1.33
$38.25
Two-Party
+$12.00
$131.00
+$2.84
$85.75
Family
+$15.50
$182.00
+$9.00
$124.50
PVC
TRADITIONAL PLAN
QHDHP
Increase from 2016
2017/18
Employee
+$2.50
$30.00 $0
$13.42
Two-Party
+$6.00
$67.50
$29.91
Family
+$8.00
$93.00
$41.00
PFP
TRADITIONAL PLAN
QHDHP
Increase from 2016
2017/18
Employee $0
$7.50
Two-Party
$17.00
Family
$23.50

27. Online Enrollment Technical Assistance
Click the Regence Online Enrollment link on the HR website – April 26th – May 31st
If you already have an account, log in – this is a separate login from your Regence.com account
First time users “Create an Account”
Identify yourself and then create a User ID and Password
Begin open enrollment process
Online Enrollment Technical Assistance
5 a.m. to 5 p.m.

28. ENROLL ONLINE

29. NETWORK OPTIONS

30. All networks include Huntsman Cancer and Primary Children's
HOSPITALS
Includes UofU & Mtn. Star
Includes all Utah Hospitals
Includes all Hospitals EXCEPT IHC
SLCC has one plan design with three network options. Focus on ValueCare being sufficient and includes all hospitals except the IHC facilities on the Wasatch Front.
All networks include Huntsman Cancer and Primary Children's

31. PROVIDERS
Includes After Hours Medical and First Med Urgent Care Centers
9400
Includes all IHC InstaCare and KidsCare Clinics
Mention that ValueCare includes all the urgent care facilities, including IHC InstaCare and KidsCare facilities

32. DENTAL PROVIDERS
1,275 GENERAL DENTISTS 291 SPECIALISTS OVER 100,000 ACCESS POINTS NATIONWIDE
Regence Traditional dental network

33. Blue Network

34. BENEFITS

35. Medical Summary Traditional Plan
July 1, 2017 through June 30, 2018
Covered Medical Services
In-network
Out-of-network
Deductible per plan year
$400 claimant
$800 family
$1,000 claimant
$2,000 family
Pharmacy deductible per plan year
$100 claimant
$300 family
Maximum out-of-pocket per plan year
$3,200 claimant
$6,500 family
$5,000 claimant
$10,000 per family
Pharmacy out-of-pocket per plan year
$2,000 claimant
$6,000 family

36. Medical Summary – Traditional Plan
Covered Medical Services
In-Network
Out-of-Network
Office visit for illness / injury
Primary Care / Specialist Visit
Other Practitioner Visit / Urgent Care
Chiropractic Care
Routine Vision and Hearing Exam
$30 copay
40%* AD
Preventive Care
Identified by age and gender
Covered at 100%
25%* AD
Imaging (CT/PET scans, MRI’s)
$50 copay AD
$50 Copay / visit & 40% coinsurance
Diagnostic, Laboratory and Radiology
includes lab and radiology performed during an office visit, and ER visit, in-patient, out-patient, minor and major
20% AD
Emergency Room
MDLive TeleHealth
$10 copay
AD = after deductible
*balance billing applies

37. QHDHP $39/visit until deductible is met – then $10 copay thereafter
Covered Service
In-Network
Out-of-Network
Deductible
$1,500 single
$3,000 family
$3,000 single
$6,000 family
Out-of-Pocket Max
$6,000 single
$12,000 family
Coinsurance
After deductible, you pay 10%
After deductible, you pay 30%*
Office/Urgent Care
After deductible, $30 co pay
Preventive Care
Covered at 100%
MDLive Telehealth
$39/visit until deductible is met – then $10 copay thereafter
Pharmacy
Retail
Mail Order
After deductible, you pay:
Generic $7
Preferred
25% to a max of $150
25% to a max of $300
Non-Preferred
30% to a max of $175
30% to a max of $437.50
Specialty
10% to a max of $250 for generic & preferred
10% to a max of $300 non-preferred
*balance billing applies
No changes to any of these benefits.
SLCC has an all-inclusive office visit copay that works like the expanded office visit rider EXCEPT for lab and radiology. All lab and radiology done at any place of service except for outpatient major diagnostic, is subject to deductible and coinsurance, including ER visits. This changed last renewal or 7/1/ This can be explained in more detail on the next slide
Major diagnostic is covered at 100% after a $50 copay and deductible.

38. Value-based medications (Usually Generic)
Optimum Value
Value-based medications
(Usually Generic)
Deductible waived on QHDHP for medications used to prevent or manage chronic conditions:
Depression
Cardiovascular Disease
Diabetes
High Cholesterol
Osteoporosis
Asthma
***Note: Medication list subject to change with 90 day notice.

39. 90-day supply for each prescription
Mail Order
After Deductible
$7 for each Generic Medication
25% for each Preferred Brand-Name Medication; up to $300 co-pay maximum per 90 day supply
30% for each Non-Preferred Brand Medication; up to $ co-pay maximum per 90 day supply
10% for diabetic supplies
90-day supply for each prescription

40. PLAN COMPARISON Traditional Plan HDHP Annual Premium Family Coverage
$2,232 PVC
$564 PFP
$2,988 PAR
$984 PVC
$0 PFP
Deductible
$400 per individual
$800 family
Pharmacy - $100/$300
$1,500 single
$3,000 family
Pharmacy – subject to medical deductible
Coinsurance
80/20%
90/10%
Out-of-Pocket max (OOP)
$3,200 per individual
$6,500 family
Pharmacy - $2,000/$6,000
$3,000 single
$6,000 family
Pharmacy – subject to medical OOP
SLCC Annual HSA Contribution*
N/A
$1,200*
*SLCC will contribute $100 per month into an employees HSA account for employees enrolled as single or family coverage in the QHDHP.

41. *SLCC will contribute $100 per month into the employee ‘s HSA account
Example 1
Example 1 – Single
Traditional
HDHP
Example:
$2,000 in medical expenses
Individual Deductible/Coinsurance
Deductible: $400
20% Coinsurance: $320
Member Total = $720
Deductible: $1,500
10% Coinsurance = $50
Member Total = $1,550
SLCC HSA Contribution
N/A
$1,200*
Insurance Pays
($1,280)
($450)
HSA Pays
($1,200)*
Member Balance
$720
$350
Member Savings
$370
Annual Premium-Single Coverage – Value Care
$322.08
Annual Premium Savings
$397.92
*SLCC will contribute $100 per month into the employee ‘s HSA account

42. *SLCC will contribute $100 per month into the employee ‘s HSA account
Example 2
Example 2 – Family
Traditional
HDHP
Example:
$35,000 in medical expenses
Individual Deductible/Coinsurance
Deductible: $800
20% Coinsurance: $5,700
Member Total: $6,500
(Out of Pocket Max is $6,500)
Deductible: $3,000
10% Coinsurance: $3,000
Member Total = $6,000
(Out of Pocket Max is $6,000)
SLCC HSA Contribution
N/A
$1,200*
Insurance Pays
($28,500)
($29,000)
HSA Pays
($1,200)*
Member Balance
$6,500
$4,800
Member Savings
$1,700
Annual Premium-Family Coverage – Value Care
$2,232
$984
Annual Premium Savings
$1,248
*SLCC will contribute $100 per month into the employee ‘s HSA account

43. Example 3 Example 3 – Pharmacy Traditional HDHP Example:
Humalog – Preferred/Formulary Medication
Pharmacy Deductible
$100 per individual
$300 per family
Subject to medical deductible
$1,500 single
$3,000 family
Average Cost of Medication
$ per script
Patient Balance
Deductible: $100
25% Coinsurance: $110.99
Member total: $210.99
Deductible = waived = Optimum Value medication
25% Coinsurance = $135.99
Member total cost $135.99
SLCC Annual HSA Contribution
N/A
$1,200
HSA Balance
$1,064.01
Humalog – 100 Unit/ML = $ Avg. Price
*SLCC will contribute $100 per month into the employee‘s HSA account

44. EMPLOYEE TOOLS

45. USING TELEHEALTH
***access to care 24 hours a day, 7 days a week, 365 days a year – Nationwide.

46. TELEHEALTH What does it cost me? Traditional PPO Plan $10 copay
HDHP Plan
$39/visit until deductible is met – then $10 copay thereafter
*Telephonic or video chat available.

47. Mobile Application Mobile Access To: Personalized Dashboard
Member ID Card
Claims and Benefits
Provider Search Tool
Learn more at: regence.com/mobile

48. Regence.com Go to – Regence.com 2. Register
3. Have your Member ID card ready.
4. Answer a series of security questions.
5. Keep your login and password in a secure place.

49. Regence.com Member Dashboard
Deductible and OOPM accumulations
Claim history
Explanation of Benefits history
Order ID cards

50. Regence.com Provider Search
Provider Search Tool