1. Open Enrollment 2017

2. Benefits Review
What is changing
What is staying the same

3. What is changing? HSA prefund and contribution limits
Pacific PPO and EPO deductibles, co-pays and/or co-insurances and premiums.
FSA increase per 2017 IRS limits from $2550 annually to $2600.

4. Pacific’s HSA Contributions
Pacific will pre-fund 3 months of the employer contributions to the HSA’s for current employees the second week of 2017
Pre-fund is $ for single and $625 for single + 1 or family
2017 IRS limits allow HSA contributions up to $3,400 for single coverage

5. Pacific Preferred Provider Organization (PPO)
Increase copay from $100 to $250 for emergency room and hospital admission
These copays apply after the PPO deductible has been satisfied.
The employee share of premiums increased

6. Pacific Exclusive Provider Organization (EPO)
Increase from zero to $150 deductible for individual and $450(x3) for family per calendar year
The deductible is waived for office visits and prescription copays.
Increase out of pocket maximum from $500/$1500 to $1500/$4500
Increase coinsurance from zero to 10% up to the out of pocket maximum
Increase copay from $100 to $250 for emergency room and hospital admission
The employee share of premiums increased

7. What is staying the same
100% preventative care component in medical plans
Prescription co-payment structure
High Deductible plans have no plan changes or rate increases
Kaiser HMO has no plan changes or rate increases
Dental Insurance
Vision Service Plan (VSP)
Flexible Spending Accounts

8. Medical plan review
Pacific Exclusive Provider Organization (Pacific EPO)
100% preventative care
$20 copay office visit
$250 for hospitalization or emergency room + 10% co-insurance
$150/$450 deductible per year
Same prescription coverage levels
Out of pocket maximum is $1500/$4500
Unlimited lifetime maximum

9. Medical plan review, cont.
Pacific Preferred Provider Organization (Pacific PPO)
100% preventative care
Employee pays 20% in network and 30% out-of-network after deductible
$250 for hospitalization or emergency room
$300/$600/$900 annual deductible
Same prescription coverage levels
Out of pocket maximum $1,500/$4,500
Unlimited lifetime maximum

10. Medical plan review cont.
Pacific High Deductible PPO Plan w/Health Savings Account (Pacific PPO w/HD & HSA)
Low premiums
100% Preventative care
20% EE and 80% ER pays after deductible (in network)
30% EE and 70% ER pays after deductible (out of network)
Incur In-network deductible- single $2,500, Family $5,000 before insurance pays (out of network same)
Same prescription coverage after deductible
Maximum Out-of-Pocket- single $5,000, Family $10,000 (separate for in and out-of-network)
Unlimited lifetime maximum

11. Dameron Ambulatory Care
$0 co-pays for PPO and EPO plans and reduced rates for PPO HD plan until deductible is met.
Physician visit $0 co-pay
Covered x-ray or lab $0 co-pay
Prescriptions at Linacia Pharmacy $0
Preventative $0 co-pay

12. Plush Care
Medical consultation with a primary health care provider over the phone
Free for Pacific PPO and EPO plans
$49 co-pay for PPO HD plan
Call

13. Medical plan review cont.
Kaiser HMO
100% paid preventative care
$20 office co-pay
$100 Hospital co-pay
$100 Emergency room co-pay
No deductible
Prescription coverage $10/$30 for 100 day supply
Out of pocket maximum $1,500/$3,000
Unlimited lifetime maximum

14. Medical plan review cont.
Kaiser High Deductible Plan w/Health Savings Account (Kaiser HMO HD w/HSA)
No premiums
100% paid preventative care
10% employee 90% employer pays after deductible
In-network $2,600, Family $5,200 Deductibles
Deductibles reset every year
Same prescription coverage after deductible
Maximum Out-of-Pocket-single $5,200, Family $10,400(separate for in and out-of-network)
Unlimited lifetime maximum

15. What is a Health Savings Account
Allows you to set aside tax-free dollars to pay for qualified health care expenses
New this year 3 month pre-fund ($312.50/$625)
Unused dollars roll over into the next year
Account balances earn interest tax-free
You own your HSA – it moves with you if you change jobs or health plans

16. Who is eligible? Employees must be enrolled in a High Deductible plan
Cannot be enrolled in another health plan
Cannot be enrolled in Medicare
Cannot be claimed as an IRS dependent by anyone
Cannot be enrolled in both HSA and FSA in the same plan year

17. Health Saving Account (HSA)
Pacific will contribute $1250 for single
$2500 for single+ 1 Family (paid in equal increments)
Employee can contribute pre-tax
NO use it or lose it rule-can roll over unused portion year after year
Contributions – expenses = savings

18. How much can be contributed? – HSA continued
2017 Contribution Limits
Single-$2,150 max EE contribution + $1,250 ER = $3,400 (employer $52.08 per pay)
2-Party or Family-$4,250 max EE contribution + $2,500 ER =$6,650 (employer $ per pay)
55+ may “catch up” contributions by - $1,000
If enrolled mid-year and fund their HSA, employee’s must remain enrolled through the following calendar year to avoid a tax penalty

19. Tax savings of an HSA Pre-tax contributions
Earnings are tax-free while the money remains in the HSA
Withdrawals for qualified health care expenses are tax free
HSA may transfer to the surviving spouse tax free
After turning 65, HSA dollars may be withdrawn for any purpose, paying only normal income taxes with no penalties.
Can be used to pay for Medicare Part A, B, D and Medicare HMO premiums (if Medicare premiums come out of your SS check you can reimburse yourself)

20. Advantages of Health Savings Accounts
You decide how much money to set aside for health care costs
You control how your HSA money is spent.
Pacific contributes to your HSA, but you own the account.
You don't pay federal taxes on employer contributions into your HSA( pay state)

21. Disadvantages to Health Savings Accounts
Illness can be unpredictable-hard to accurately budget for expenses
Information about the cost and quality of medical care can be difficult to find
Challenging to put money into a HSA. If you use your health care more often you may not be able to save as much as someone who does not
Pressure to save money in HSA might lead one to not seek medical care when needed
Money withdrawn for nonmedical expenses is taxable

22. Rates-per pay period

23. Delta Dental PPO Preventative care paid 100% 3 cleanings per year
Annual deductible $50/$150
Basic Services – after deductible 90%
Major Service – after deductible 60%
Annual maximum per person $2,000
Orthodontics (6 mo. waiting period)
50% after deductible, $2,000 lifetime max.

24. DeltaCare USA, DHMO No premiums
Preventative care – 1 cleaning every 6 mo.
No annual deductible
Clearly defined out of pocket costs
No restrictions on preexisting conditions
Covers many diagnostic and preventative services at no cost
No annual or lifetime maximums
Orthodontics – no waiting period

25. VSP (Vision Service Plan)
Annual deductible $25
Exams once per year 100% covered
Lenses every 24 months 100% covered
Frames every 24 months up to $120 covered

26. Voluntary Life Insurance
Employees* - up to 5 times annual salary
Spouses* - $10k to $50k in $10k increments
Child*(ren) -$5k, $10k or $20k – single price for one or more children
Spouse or child coverage can not exceed 50% of employee’s combined Basic and Voluntary Term life volume of coverage
Includes equal amounts of AD and D coverage.
*Proof of good health forms will need to be provided to vendor, who will decide if the insurance is granted or not.

27. Flexible Spending Accounts
Set aside pre-tax dollars for qualified expenses
Debit card issued with online access to balances
Must enroll annually in this plan
Health Care Account- $2,600 Maximum Annual Limit
Dependent Day Care Account - $5,000 Maximum Annual limit
$500 roll over only

28. Benefit Fairs
Stockton – Thursday, November 3rd from 11-2 in the DeRosa Center Ballroom
San Francisco – Tuesday, November 8th from 10-2 in the Executive Conference Rm 437
Sacramento – Wednesday, November 9th from 11-1 in Lecture Hall S2 and S3

29. Going forward Open Enrollment is November 1st through December 2nd
Firm deadline of December 2nd for all enrollment change forms
Look for your Open Enrollment materials that were sent to your home
View our University Benefits website at:

30. Next steps Review Open Enrollment materials sent to your home
Attend a benefits fair
Ask questions
Enroll in benefits the way you will use them
Turn in enrollment change form to HR
Continue to learn more about benefits

31. Open Enrollment November 1 - December 2
Questions?