1. AuSable Valley Employee Benefits Meeting 2017

2. Introductions The Team: Presented by: Kevin Elliott Account Executive
Julie Hock Group Benefits Coordinator/Executive
The Team:
Kevin Elliott
Julie Hock
Nancy Swiatowy

3. Today’s Agenda Review health care coverage
Assess health care trends and health care review process
Overview of benefit plan changes and rates
Learn how to maximize your benefits
Review other benefits
Voluntary Dental coverage
Long-term disability
Life insurance
Understand next steps
Open Enrollment Video

4. Rising Health Care Costs: A National Trend
Why are health care costs increasing?
Aging population
Increased utilization and consumer demand
Reduction in provider discounts
Increase in prescription drug costs
Consolidation of managed care companies
New medical technology
Did you know: A can of coke has 150 calories, all from sugar. You would have to run for about 30 minutes to burn off those extra calories.

5. Health Care and AuSable Valley
The Review Process
Claims Analysis
Deductible Utilization
Prescription drug utilization
Preventative benefits
Premium Increase % increase
Public Act 152 Hard Cap – 3.3% increase

6. Plan Design Changes HSA 2000 HSA 3000 PPO 4000 Same plan as 2016
New Plan:
Higher deductible
Lower monthly premium than the HSA 2000 option
PPO 4000
New Plan: “Standard Plan”
Highest deductible
No monthly premium
Doctor Copay/Prescription Coverage before deductible

7. Plan Designs: At-A-Glance
Simply Blue HSA 2000/20%
Aggregate
Simply Blue HSA 3000/20%
Embedded
Simply Blue $4,000
General Plan Information    
Annual Deductible
$2,000/$4,000
$3,000/$6,000
$4,000/$8,000
Coinsurance
20%
30%
Annual Out-of-Pocket Limit  
$6,350/$12,700
Office Visit
Covered 80% after deductible.
$30
Spec/Urgent/ER
$50/$150/$60
Prescription
$10/$40/$80 after deductible.
$15/$50/50%/20%/25%

8. 2017 Rates Monthly HSA 2000 HSA 3000 PPO 4000 Single $91.58 $76.05
$0.00
2 Person
$178.83
$111.54
Family
$192.31
$152.10

9. HSA Benefits Company Provided Contribution HSA 2000 (one time)
HSA contribution dollar for dollar match/monthly for both plans
How it is paid:
3 equal installments in January, May and September
Per pay period based on your personal contribution
Single
$ TOTAL
$42.00 installments
$ TOTAL
$ installments
$ maximum
2 Person
$ TOTAL
$84.00 installments
$ TOTAL
$ installments
$ maximum
Family

10. HSA Contribution Limits 2017
2017 limits: (combination of AVCMH and employee contribution and AVCMH match)
$3,400 for individual coverage
$6,750 for family and 2-person coverage
For individuals ages 55-plus, the IRS allows additional “catch- up contributions.”
Eligible individuals may contribute an extra $1,000 for the year.

11. Aggregate vs Embedded Deductible
Aggregate Deductible: (HSA 2000)
There is not an individual deductible embedded in the family deductible. In this situation, before your insurance helps you pay for any of your medical bills the entire amount of the deductible must be met first. It can be met by one family member or a combination of family members however there are no benefits until expenses equaling the deductible amount have been incurred.
Embedded Deductible: (HSA 3000)
If you are on a family medical plan with an embedded deductible, your plan contains two components, an individual deductible and a family deductible
EXAMPLE: If you, your wife and daughter are on a family plan with a $6000 family embedded deductible, and the individual deductible is $3000, if your daughter incurs $3000 in medical bills, her deductible is met and any subsequent medical bills for your daughter that year, your insurance will help pay even though the family deductible of $6000 has not been met yet.

12. Comparison 1-Based on Single
 Hospital Bill $10,000.00
Simply Blue HSA 2000/20%
Premium-$91.85/month
Simply Blue HSA 3000/20%
Premium-$76.05/month
Simply Blue $4,000
$0.00/month
General Plan Information    
Deductible you pay toward the bill:
Coinsurance %
$2,000
20%
$3,000
$4,000
30%
Total amount paid with deductible and coinsurance
$5,800
Annual Out-of-Pocket Limit  
$6,350
Yearly Premium $
$912.60
$0.00
HSA One Time Contribution
$125
$500
Total out of pocket based on this example: (including premiums) $ $
$5,800.00
HSA Tax Savings on Deductibles and Copays not included in this example

13. HSA Tax Savings on Deductibles and Copays not included in this example
Comparison 1-Based on Family(2-Person) –example showing one person meeting deductible
 Hospital Bill $10,000.00
Simply Blue HSA 2000/20%
Premium-$91.85/month
Aggregate
Simply Blue HSA 3000/20%
Premium-$76.05/month
Embedded
Simply Blue $4,000
$0.00/month
General Plan Information    
Deductible you pay toward the bill:
Coinsurance %
$4,000
20%
$3,000
30%
Total amount paid with deductible and coinsurance
$5,200
$5,800
Annual Out-of-Pocket Maximum 
$6,000
$6,350
Yearly Premium $
$912.60
$0.00
HSA One Time Contribution
$250
$1000
Total out of pocket based on this example: (including premiums)
$6,052.20 $
$5,800.00
HSA Tax Savings on Deductibles and Copays not included in this example

14. Comparison 2-Based on Single
 3 Doctor Visits ($150 each) and Wellness Physical
Simply Blue HSA 2000/20%
Premium-$91.85/month
Simply Blue HSA 3000/20%
Premium-$76.05/month
Simply Blue $4,000
$0.00/month
General Plan Information    
Deductible you pay toward the bill:
Coinsurance %
$2,000
20%
$3,000
$4,000
30%
Total amount paid with deductible and coinsurance
$450.00
3 office visits and $0.00 for Wellness Physical
$90.00
3 office visits with $30 copay and $0.00 for Wellness Physical
Annual Out-of-Pocket Limit  
Yearly Premium $
$912.60
$0.00
HSA One Time Contribution
$125
$500
Total out of pocket based on this example: (including premiums) $
$826.60
HSA Tax Savings on Deductibles and Copays not included in this example

15. Comparison 2-Based on Family(2-Person)
 3 Doctor Visits ($150 each) and Wellness Physical
Simply Blue HSA 2000/20%
Premium-$91.85/month
Aggregate
Simply Blue HSA 3000/20%
Premium-$76.05/month
Embedded
Simply Blue $4,000
$0.00/month
General Plan Information    
Deductible you pay toward the bill:
Coinsurance %
$2,000
20%
$3,000
$4,000
30%
Total amount paid with deductible and coinsurance
$450.00
3 office visits and $0.00 for Wellness Physical
$90.00
3 office visits with $30 copay and $0.00 for Wellness Physical
Annual Out-of-Pocket Limit  
Yearly Premium $
$912.60
$0.00
HSA One Time Contribution
$250
$1000
Total out of pocket based on this example: (including premiums) $
$326.60
HSA Tax Savings on Deductibles and Copays not included in this example

16. Comparison 3-Based on Family(2-Person) –example showing more than one person getting services toward deductible
 Hospital Bills $10, Person A
$5,000-Person B
Simply Blue HSA 2000/20%
Premium-$91.85/month
Aggregate
Simply Blue HSA 3000/20%
Premium-$76.05/month
Embedded
Simply Blue $4,000
$0.00/month
General Plan Information    
Deductible you pay toward the bill:
Coinsurance %
$4,000
20%
$6,000
30%
Total amount paid with deductible and coinsurance
$6,200
$7,800
$10,100
Annual Out-of-Pocket Maximum 
$6,000-max you could pay for the year
$8,000 –max you would pay in the year
$12,700 –max you would pay in the year
Yearly Premium $
$912.60
$0.00
HSA One Time Contribution
$250
$1000
Total out of pocket based on this example: (including premiums)
$6,927.20
$7,712.60
HSA Tax Savings on Deductibles and Copays not included in this example

17. How to choose the right plan…
Know your medical/claims history
Know your budget
Crunch the numbers
Don’t let the premium trick you
Diebold Insurance will be available December 1-2 if you have questions or need help deciding

18. Preventative Benefits
Preventive services keep you healthy
Immunizations and flu shots can stop illnesses before they have a chance to start. That one trip to the doctor can save you many more down the road. 
Health screenings and wellness exams can discover problems you may not know you have. Finding them early before they have a chance to get worse means they’ll be easier and cheaper to treat. These preventive services can potentially save your life

19. Preventative Benefits
Preventive services are free
You won’t have to worry about a copay, coinsurance or your deductible, as long as you see an in-network doctor and your visit is just about preventive care.
You might have to pay out-of-pocket expenses if:
You receive other services during the same visit that are not preventive
The services are used to treat, diagnose or monitor an illness, injury or health problem

20. Qualified HSA Medical Expenses
Examples of qualified medical expenses include:
Most medical care that is subject to your deductible (copays, coinsurance, doctor visits, inpatient or outpatient treatment, etc.)
Prescription drugs
Over-the-counter drugs, only if you obtain a prescription
Insulin (with or without a prescription)
Dental and vision care
Select insurance premiums
COBRA, qualified long-term care insurance, health insurance premiums paid while receiving unemployment benefits, health insurance after you turn 65 except for a Medicare supplemental policy
For a complete list please see Publication 502-irs.gov
Did you know: you will burn 7% more calories walking on hard dirt than on pavement.

21. Flexible Spending Account (FSA) Highlights
Pre-tax program for medical and dependent care expenses
Medical expenses: you can contribute up to $2600 per year
Can only be used if you have the “standard plan” PPO 4000
Dependent care expenses: you can contribute up to $5000 per year
You must re-enroll each year
Did you know: Stretching when you first wake up can boost circulation and digestion and helps to ease back pain.

22. Qualified FSA Medical Expenses
Examples of qualified medical expenses include:
Deductible and copayments for group health and/or dental plan
Eye exams, eyeglasses and contact lenses
Hearing exams and hearing aids
Exams and treatments that exceed the annual frequency covered by the plan (example: physical exams in excess of one per year)
Prescription drugs
Medical equipment and supplies (such as crutches, bandages and diagnostic devices)
Insulin and blood sugar test kits
For a complete list please see Publication 502-irs.gov

23. Voluntary Dental Plan Highlights
Delta Dental of Michigan
General Plan Information    
Annual Deductible
None
Maximum per person per calendar year– diagnostic & preventive, basic, and major services
$1,000 per person
Lifetime Orthodontia Maximum per Patient
Covered Services
Diagnostic and Preventive Services
50%
Basic Services
Major Services
Orthodontic Services– up to age 19

24. Voluntary Dental Plan Rates
Monthly Dental Premiums
Plan remains the same as the 2016 Delta Dental Plan
Estimated based on 35% enrollment
Single
$17.54
Double
$35.89
Family
$68.68
Did you know: Typically the longer the ingredient list and the harder it is to pronounce the words, the less healthy it is for you.

25. Company-paid Benefits
Long-term Disability (LTD)
60% of Earnings with max of $6,000
180 Day Elimination Period
See Employee Benefit Book for more details
Life and Accidental Death & Dismemberment (AD&D)
$25,000, see Employee Benefit Book for more details
Who is your beneficiary??

26. Enrollment Periods Initial Enrollment Period Open Enrollment Period—
Newly eligible employees enroll in coverage
Open Enrollment Period—
ENDS December 2, 2016
Eligible employees may enroll in coverage for the upcoming plan year
Mid-year Enrollment Periods
Employees enroll for coverage during the plan year (often triggered by major life events, such as marriage or having a baby)

27. Resources Mobile App Demo Digital Tools and Resources www.bcbsm.com
Manage Your Health & Wellness
24/7 Online Health Care
Shop for Deals
Compare Doctors/Facilities
EOB’s online
Mobile App Demo

28. Questions? Thank you for your time!
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