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2014-2015 Mesa Schools Open Enrollment AGENDA Open enrollment period Overview of Medical Plan Options Cigna Tools and Resources Questions 1.

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Presentation on theme: "2014-2015 Mesa Schools Open Enrollment AGENDA Open enrollment period Overview of Medical Plan Options Cigna Tools and Resources Questions 1."— Presentation transcript:

1 2014-2015 Mesa Schools Open Enrollment AGENDA Open enrollment period Overview of Medical Plan Options Cigna Tools and Resources Questions 1

2 2014-2015 Open Enrollment July 21 – August 8 Plan year: October 1, 2014 – September 30, 2015

3 Overview of Medical Plan Options

4 4 Medical Plan Highlights OAP Copay (EPO)HDHP 1500HDHP 2500 SingleFamilySingleFamilySingleFamily Deductible$350 $700 per family of 2 $1050 for family of 3 or more $1,500 In-network $3,000 Out-of-network $3,000 In-network $6,000 Out-of-network $2,500 In-network $5,000 Out-of-network $5,000 In-network $10,000 Out-of-network Out-of-pocket limit $2,350 includes deductibles, copayments and coinsurance $7,050 includes deductibles, copayments and coinsurance $3,000 In-network $6,000 Out-of-network $6,000 In-network $12,000 Out-of-network $2,500 In-network $5,000 Out-of-network $5,000 In-network $10,000 Out-of-network Co-insurance 20% up to OOP limit Office Visit $20 PCP $35 Specialist $20 PCP $35 Specialist Deductible Applies Preventive Care Covered at 100% Pharmacy (30 days supply) $7 generic/$15 Preferred Brand/40% to $100 max Non Preferred Brand 20% after plan Deductible 0% (plan covers at 100%) after plan Deductible HSA contribution from employer n/a $1,000$1,500

5 Prescriptions Generic medicines available for $4 at Target, Wal-Mart, and now Fry’s CIGNA Tel-Drug (mail order) delivers prescription medications directly to your home or other location you specify – Ideal for those who take medications regularly – Convenient home delivery – 90-day supply QuickSwitch  Transfers means no more paperwork for you – Order online, by phone or mail – Free standard delivery shipping – Three ways to order: – By Mail – By Phone – 1-800-Tel-Drug (835-3784) – Online – www.teldrug.com or myCIGNA.com 5

6 HEALTH SAVINGS PLAN AND YOU A tax-advantaged HDHP provides coverage for current health care expenses with the option to save for future health care expenses Combines a qualified high-deductible medical plan (medical/pharmacy coverage) with a Health Savings Account You, your employer, or both, can contribute to the Health Savings Account which is owned by you Money contributed to the Health Savings Account is generally not taxable* You have investment options with the Health Savings Account 6 + = Qualified high deductible medical plan (HDHP) Tax- advantaged HDHP Health Savings Account * HSA contributions and earnings are not subject to federal taxes and not subject to state taxes in most states. A few states do not allow pretax treatment of contributions or earnings. Please consult your personal tax advisor or contact your plan administrator for information about your state. Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

7 ARE YOU ELIGIBLE TO PARTICIPATE? Because HSA plans have certain tax advantages, the IRS defines specific rules for participation. To be eligible, you: Must be enrolled in an IRS-qualified high-deductible medical plan (high-deductible medical plans offered with Cigna’s Choice Fund HSA meet IRS requirements) Cannot have any other health coverage –Not covered by spouse’s medical or pharmacy plan –Not covered through Medicare Part A or Part B –Not covered through a general-purpose Flexible Spending Account (FSA) plan (either employer’s or spouse’s) Cannot be claimed as a dependent on another person’s tax return 7 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

8 YOUR HSA MAXIMUM CONTRIBUTION The IRS has set the following limits for 2014/2015: Under age 55 (based on a 12-month period): –Up to $3,300/$3,350 individual coverage* –Up to $6,550/$6,650 family coverage* Age 55 or older: –Maximum contribution increases by $1,000 (considered a “catch-up” contribution) –Up to $4,300/$4,350 individual coverage* –Up to $7,550/$7,650 family coverage* 8 *Contributions to your HSA that you receive from your employer and incentives count toward your maximum. $ Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

9 9 This is an example used for illustrative purposes only. Single, in her 50s Heart disease; controlling health through medication Looking to save money for future health expenses meet Karen HDHP 1500 HSA EMPLOYER $1000 KAREN $500 $1,500.00 + PLAN 80% KAREN 20% + PLAN 100% IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100% $1,948.00 80% plan: $1,558.40 20% Karen: 389.60 Deductible: –$1,500.00 TOTAL EXPENSES Preventive care$ 398.00 ER visit2600.00 4 PCP visits320.00 12 Generic Rx288.00 3 Brand Rx240.00 TOTAL3,846.00 100% covered–398.00 MPS HSA Contribution -1000.00 Karen’s HSA Contribution –500.00 80% plan–1558.40 20% Karen–389.60 BALANCE DUE0.00 Karen pays$ 889.60 $0 HSA BALANCE Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

10 10 This is an example used for illustrative purposes only. Single, in her 50s Heart disease; controlling health through medication Looking to save money for future health expenses meet Karen HDHP 2500 HSA EMPLOYER $1500 KAREN $1000 $2500.00 + PLAN 100% KAREN 0% + PLAN 100% IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100% $948.00 100% plan: $948.00 0% Karen: 0.00 Deductible: –2500.00 TOTAL EXPENSES Preventive care$ 398.00 ER visit2600.00 4 PCP visits320.00 12 Generic Rx288.00 3 Brand Rx240.00 TOTAL3,846.00 100% covered–398.00 MPS HSA Contribution -1500.00 Karen’s HSA Contribution -1000.00 100% plan–948.00 0% Karen0 BALANCE DUE0.00 Karen pays$1000.00 $0 HSA BALANCE Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

11 $3448 11 This is an example used for illustrative purposes only. Single, in her 50s Heart disease; controlling health through medication Looking to save money for future health expenses meet Karen OAP Copay (EPO) HSA – N/A EMPLOYER $0 KAREN $0 + PLAN Schedule KAREN Deductible + PLAN 100% IN-NETWORK PREVENTIVE CARE IS COVERED BY THE PLAN AT 100% Plan-Pays per schedule: $2,689 Copays:$309 Deductible: $350 RX Deductible: $100 TOTAL EXPENSES Preventive care$ 398.00 ER visit2600.00 4 PCP visits320.00 12 Generic Rx288.00 3 Preferred Brand Rx240.00 TOTAL$3846.00 100% covered–398.00 Plan Pays-2689.00 ER Deductible and copay -350.00 -100.00 4 Copays-PCP Visits-80.00 Rx Deductible-100.00 12 Generic RX Copays 3 Brand Rx Copays -84.00 -45.00 BALANCE DUE0.00 Annual EO premium480.00 Karen Pays$1239.00 Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna + Copays

12 Cigna Tools & Resources

13 SAVING YOU TIME myCigna.com –Print forms or print/order ID cards –Check your coverage and explanation of benefits –Track claims, payments and deductibles –Sign up for online coaching programs –Keep track of your health history and records with an online personal health record –Find in-network doctors, specialists, hospitals and labs –Learn about common health problems and treatment options –Compare treatment and procedure costs –Find cost and quality ratings for doctors and hospitals –Switch a prescription to Cigna Home Delivery Pharmacy with one easy phone call, and have your medications delivered to your door 13 No claim forms needed in-network Talk with a health specialist when you can’t reach your doctor – day or night Confidential, unpublished property of Cigna. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2014 Cigna

14 14 If You Have Questions About Your Medical Plan Options… Cigna’s Pre-Enrollment Hotline 24 hours a day, 7 days a week 365 days a year! 1-800-401-4041 Open Enrollment Ends August 8

15 Questions?


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