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Welcome to Benefits Enrollment

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Presentation on theme: "Welcome to Benefits Enrollment"— Presentation transcript:

1 Welcome to Benefits Enrollment
November 14 - November 30, 2016

2 Today, you will Address savings opportunities
Get an overview of your Medical plan options Address savings opportunities Review New Opportunities to protect your family Assets

3 Medical Plan Options CORE PLAN $2000 - 100% HSA with Preventive Rx
Non-Embedded Preventive Care 100% Coverage Deductible Individual Contract Family Contract $2,000 $4,000 Out of Pocket Maximum District HSA Contribution $1,650 $3,300 Total Monthly Premium Single Family $ $1,704.07 Employee Monthly Premium Certified Staff and 12-Month Employees* Single $ 49.60 $ *Benefit prorated based on FTE *9-Month Employees Please contact the District office for your pro-rated premium BUY-DOWN PLAN $ % HSA with Preventive Rx Embedded Preventive Care 100% Coverage Deductible Per Person Per Family $3,500 $7,000 Out of Pocket Maximum District HSA Contribution Individual Contract Family Contract $2,048.59 $4,203.86 Total Monthly Premium Single Family $668.76 $1,516.28 Employee Monthly Premium Certified Staff and 12-Month Employees* Single $ 0.00 *Benefit prorated based on FTE *9-Month Employees Please contact the District office for your pro-rated premium

4 Individual Contract Maximum Employee Spend
Maximum Exposure BUY-DOWN PLAN $ % HSA with Preventive Rx Embedded Employee Annual Premium: Individual Contract Family Contract $0 Annual Deductible: $3,500 $7,000 Maximum Exposure (before HSA) District HSA Contribution $2,049 $4,204 Individual Contract Maximum Employee Spend $1,451 Family Contact Maximum Employee Spend: First Family member All Remaining Family Members $2,796 CORE PLAN $ % HSA with Preventive Rx Non-Embedded Employee Annual Premium: Individual Contract Family Contract $595 $1,350 Annual Deductible: $2,000 $4,000 Maximum Exposure (before HSA) $2,595 $5,350 District HSA Contribution $1,650 $3,300 Maximum Employee Spend: $ 945 $2,050 What you are saving in premium dollars will become taxable income….save yourself tax dollars by investing it in your HSA Invest Savings in HSA or 403(b)

5 HSA Contributions Reduce your taxable income by investing in the HSA!
Coverage Type Maximum Contribution District Contribution CORE PLAN Employee Maximum Contribution CORE PLAN District Contribution BUY-DOWN PLAN Maximum Contribution BUY-DOWN PLAN Single $3,400 $1,650 $1,750 $2,048.59 $1,351.41 Family $6,750 $3,300 $3,450 $4,203.86 $2,546.14 Reduce your taxable income by investing in the HSA! Premium savings between current traditional and Core Single; Family Premium savings between current traditional and Buy-Down Single; 2, Family Participants age 55 or older who are not enrolled in Medicare, are eligible to make a catch up contribution of up to $1,000 over the Maximum Annual Contribution shown above Review HSA Eligibility Guidelines on page 6 & 7 of Benefit Decision Guide

6 Value Added Resources Healthy Pregnancy Program
Medica CallLinkSM Nurseline Main Street Medica Employee Assistance Program Work-life benefits Tobacco Cessation Program Fit Choices® by Medica Health club reimbursement My Health Rewards by MedicaSM HSA

7 Medica Health Rewards

8 (Established Patient)
Be Cost Conscious Condition Primary Care Clinic (Established Patient) Convenience Care Urgent Care Center Emergency Department Allergies $189 $65 $200 $545 Bronchitis, Acute $595 Bronchitis, Chronic $185 $214 $665 Earache $181 $210 $600 Pharyngitis (sore throat) $198 $224 $625 Pink Eye $176 $202 $570 Sinusitis $212 $617 Strep Throat $193 $223 $531 Upper Respiratory Infection $183 $211 $586 Urinary Tract Infection For illustrative purposes only. Not actual pricing. =$45

9 Cost is $45 instead of ER or Urgent Care
No charge if they cannot treat Simple, convenient and safe Treats over 55 common conditions 98 percent of customers highly recommend* Easy to use When you visit virtuwell.com, you take a quick online interview. Then, a nurse practitioner looks at your answers, completes your personal diagnosis and sends you a treatment plan with a prescription, if needed. If you need to see a doctor in person, virtuwell will tell you before you enter any personal information. It’s that easy. If you’re not completely satisfied with your experience — for any reason — virtuwell will refund your money. Saves you money virtuwell costs just $45 — less than the cost of going to the doctor. If you use your HealthPartners insurance, you’ll pay the same amount as a convenience clinic visit. Treats many common illnesses virtuwell treats over 55 common conditions including: • Cold • Cough • Allergy • Flu • Pinkeye • Sinus infection • Acne • Bladder infection • Yeast infection • Lice • Stye • Rashes and other skin irritations *Source: virtuwell patient satisfaction survey

10 Pharmacy Savings Opportunity
Every 1% in generic use saves 7% in drug trend Every 1% in generic use saves 7% in drug spend

11 How much do you have to pay?
Therapeutic Use Non-Formulary or Brand-Name Drug Name AWP for 30-Day Supply* Generic or Formulary Alternative Drug Name Generic or Formulary Alternative Savings High cholesterol Lipitor® - 20 mg. $136.20 Simvastatin - 40 mg. $26.70 $109.50 Heartburn, ulcer treatment Nexium® - 20 mg. $163.80 Omeprazole - 20 mg. $32.10 $131.70 Depression Celexa® - 20 mg. $99.60 Citalopram - 20 mg. $6.90 $92.70 Allergies, rhinitis Flonase® - nasal spray $94.70 Fluticasone-nasal spray $45.90 $48.80 Insomnia Ambien® - 10 mg. $154.20 Zolpidem - 10 mg. $65.70 $88.50 Bacterial infection Zithromax® mg. $57.70 Azithromycin mg. $28.70 $29.00 Zyrtec® - 10 mg. $76.50 Loratadine - 10 mg. $4.50 $72.00 High blood pressure Altace® - 10 mg. $71.70 Lisinopril - 10 mg. $3.30 $68.40 For illustrative purposes only. Not actual pricing.

12 Flexible Spending Account
Medical FSA - $2,550 Limit Standard Medical, Dental, Vision, Limited Purpose Dental & Vision Only Dependent Care FSA - $5,000 Limit Note: use it or lose it applies Like an HSA, funds set aside in a Flexible Spending Account are excluded from taxable income

13 Consider your Tax Savings
With HSA or FSA W/O HSA or FSA Gross Income $40,000 Your HSA Contribution $2,500 $0 Net Taxable Income $37,500 Taxes -$5,161 -$5,771 Take Home Pay $32,339 $34,229 Pay + Tax Deferred Savings $34,839 Savings due to reduced Taxation $610

14 Find a participating provider:
Your Dental Benefits Type of Service Dental Benefit In-Network Deductible None Preventive Services 100% Basic Services (i.e. sealants, fillings) 80% Major Services (i.e. crowns, dentures) Orthodontia 50% Orthodontia Lifetime Maximum $1,500 Calendar Year Maximum $1,000 Find a participating provider:

15 Your Vision Benefits Find a participating provider:
Type of Services Vision Benefit In-Network Vision Network Davis Vision Exams (every 12 months) $10 copay then 100% Lenses (every 12 months) See Benefit Schedule Contacts in lieu of eye glasses (every 12 months) $25 copay then $100 allowance Frames (every 24 months) Fashion $0 Copay, Designer $20 Copay, Premium $40 Copay $100 allowance Laser Vision Correction Up to 25% off retail Find a participating provider:

16 Social Security Normal Retirement Age (SSNRA)
Your Income Protection Plans Employee Paid STD Benefit Overview Benefit Begins 1st day of an accident, 4th day of an illness Benefit Duration 13 weeks Weekly Benefit 66 2/3% of weekly pay Maximum Benefit $750 Guarantee Issue $350 Pre-existing Condition Limits 6 / 12 Months Rate per $10 of benefit $0.082 District Paid LTD Benefit Overview Benefit Begins 9 days Benefit Duration Social Security Normal Retirement Age (SSNRA) Monthly Benefit 90% of monthly salary Maximum Benefit $10,500 Month

17 Your Life Plans One Time Opportunity for GUARANTEED Coverage
District Paid Term Life and AD&D Life Benefit 1x Earnings* AD&D Benefit Same as life benefit *Earnings is calculated on both your annual salary and any extra - curricular Age reduction schedule applies. See plan certificate for details. One Time Opportunity for GUARANTEED Coverage Employee Paid Voluntary Term Life and AD&D Employee Benefit Minimum of $10,000 Maximum of $500,000 not to exceed 5x earnings Guarantee Issue of $110,000 Spouse Benefit Minimum of $5,000 Maximum up to 100% of employee amount Guarantee Issue = $25,000 Child(ren) Benefit Minimum of $2,000 Maximum of $10,000 Guarantee Issue = $10,000 You must elect life coverage for yourself in order to cover your spouse and/or children.

18 Voluntary Life Plan To insure your insurability:
Employees $10,000 Spouse $5,000 Child(ren) $2,000 HSA & FSA forms required!! Those current elections will not automatically continue.

19 Invest for Retirement Year Basic Elective Contribution Limit Age 50+ Catch-Up 2017 $18,500 $6,000 *2017 contribution limits are estimates only, final figures will be released by the IRS by the end of 2016.

20 All Employees Must Take Action!!

21 Open Enrollment Ends November 30, 2016
All forms must be returned to Elaine before the end of Open Enrollment


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