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Employee Benefits SAINT LOUIS UNIVERSITY 2011 Annual Enrollment
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Benefits Overview—Coverages Offered Medical/Pharmacy Voluntary Dental Employee Term Life and Accidental Death & Dismemberment (AD&D) Voluntary Term Life Voluntary AD&D Long Term Disability Flexible Spending Accounts Business Travel Accident S:\EB\Clients\STLLU08\EE Communications\2010\Enrollment Presentation.pptx 1
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Medical/Pharmacy Benefits Annual Enrollment 2011
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Highlights Effective January 1, 2011 The Vitality™ Wellness Program –Save on premium and earn rewards! –Health screenings are needed to participate in the Vitality program Medical changes –Lifetime maximum on both plans will be unlimited –Preventive care is covered at 100% –Pricing will be done on four tiers: Employee, Employee & Spouse, Employee & Child(ren), or Family No Dental plan design changes Eligibility Changes: –You can now cover adult children to age 26 regardless of student or marital status on both the medical and dental insurance Express Scripts –Ninety-day prescriptions will no longer be available at retail pharmacies but can still be obtained via mail order Flexible Spending Accounts (FSAs) –Over-the-counter (OTC) Medication will no longer be reimbursable under FSA programs due to Federal health care reform S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 3
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Primary PlanPlus Plan SLUCareIn-Network Out-of- NetworkSLUCareIn-Network Out-of- Network Deductible Individual$250$500$1,000$0$250$750 Family$500$1,000$2,000$0$500$1,500 Coinsurance0%20%40%0%10%40% Out-of-Pocket Maximum (includes deductibles) Individual$1,250$2,500$5,000$0$1,250$4,750 Family$2,500$5,000$10,000$0$2,500$9,500 Physician Office Visits Primary Care$10 copay20% after deductible 40% after deductible $10 copay10% after deductible 40 % after deductible Specialist Care$20 copay Inpatient Hospital 10% after deductible 20% after deductible 40% after deductible 0% after deductible 10% after deductible 40% after deductible Emergency Room $100 copay Urgent Care Center $50 copay UnitedHealthcare Plans S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 4
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UnitedHealthcare Plans S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx Primary PlanPlus Plan Express Scripts Retail Network Pharmacy (34-day supply) Mail Order (90-day supply) Express Scripts Retail Network Pharmacy (34-day supply) Mail Order (90-day supply) Tier 1$10$20$10$20 Tier 2$25$50$25$50 Tier 3$40$80$40$80 5 For more information on your prescription drug coverage, please visit: www.express-scripts.comwww.express-scripts.com
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Copays You only have copays in THREE scenarios: 1)Physician office visits for SLUCare ONLY! Both the Primary and Plus plans offer $10 primary care physician and $20 specialist office visit copays. All other UHC in-network physician office visits are billed at the discounted rate and apply to your deductible and coinsurance 2)Urgent Care and Emergency Room Facilities Both the Primary and Plus plans offer $50 urgent care facility and $100 emergency room copays both in- and out-of-network. 3)Rx Drugs Both the Primary and Plus plans offer copays for Rx drugs: 6 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx Primary PlanPlus Plan RxRetail (30 Days)Mail Order (90 Days)Retail (30 Days)Mail Order (90 Days) Generic$10$20$10$20 Preferred Brand$25$50$25$50 Non-Preferred Brand $40$80$40$80
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Illustrative Medical Scenario You visit a SLUCare doctor at a UHC-contracted hospital for an inpatient surgery; $1,250 in Physician charges and $5,000 in facility charges (after UHC discounts) –PRIMARY PLAN Doctor’s Charges: $250 deductible (SLUCare specific, cross applies to in-network deductible), then 10% coinsurance (10% x $1,000 = $100) –$250 + $100 = $350 Facility Charges: $500 deductible (UHC in-network deductible, cross applies with SLUCare deductible; only $250 remains), then 20% coinsurance (20% x $4,750 = $950) –$250 + $950 = $1,200 TOTAL = $1,550, leaving $950 on your out-of-pocket maximum ($900 on the SLUCare specific out-of-pocket maximum) –PLUS PLAN Doctor’s Charges: $0 deductible (SLUCare specific), 0% coinsurance –$0 + $0 = $0 Facility Charges: $250 deductible (UHC in-network deductible), then 10% coinsurance (10% x $4,750 = $475) –$250 + $475 = $725 TOTAL = $725, leaving $525 on your out-of-pocket maximum 7 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
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Tips For You to Help Save Money As an employee, you can take ownership in you and your family’s health care Consumers can control costs by: –Using less expensive and more efficient providers (i.e., in-network) –Using appropriate providers (i.e., urgent care versus emergency room for non-emergencies) –Requesting generic prescriptions or prescriptions on lower tiers when available –Using mail order for maintenance prescriptions S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 8
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UnitedHealthcare’s Member Website www.myuhc.com: Find participating providers Check claim status and history Learn more about your benefits Track deductibles, out-of-pocket expenses and lifetime maximums Estimate and compare treatment costs S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 9
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Medical Payroll Deductions PrimaryPlus Monthly WITH Wellness WITHOUT Wellness WITH Wellness WITHOUT Wellness Single$39.62$59.62$68.97$88.97 Employee & Spouse$236.98$256.98$298.63$318.63 Employee & Child(ren)$214.41$234.41$270.19$290.19 Family$338.55$358.55$426.61$446.61 Subsidy Coverage$0.00$20.00 Bi-Weekly WITH Wellness WITHOUT Wellness WITH Wellness WITHOUT Wellness Single$18.29$27.52$31.83$41.06 Employee & Spouse$109.38$118.61$137.83$147.06 Employee & Child(ren)$98.96$108.19$124.70$133.93 Family$156.25$165.48$196.90$206.13 Subsidy Coverage$0.00$9.23 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 10
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Voluntary Dental Benefits Annual Enrollment 2011
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Voluntary Dental Benefits Coverage will continue through Delta Dental Choose between three dental plan options Benefits will remain the same for 2011 Contributions increasing 7% S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 12
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Voluntary Dental Plan—Delta Dental S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx Flex OptionBasic PlusBasic In-NetworkOut-of-Network In-Network Only Deductible Individual$50 $25 Family$150$50$75 Calendar Year Maximum Per person$1,000 $750 Preventive Care 0% no deductible Basic Restorative Care 10% after deductible 30% after deductible Major Restorative Services 40% after deductible 60% after deductible 65% after deductible Not covered Orthodontia Lifetime maximum (per person)$1,000 Not covered Orthodontia 50% For adults and children 60% For adults and children 50% For children only Not covered 13
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Dental Payroll Deductions FlexBasic PlusBasic Monthly Single$31.01$20.24$14.45 Two-person$60.70$38.42$28.08 Family$103.91$65.36$50.23 Bi-Weekly Single$14.31$9.34$6.67 Two-person$28.02$17.73$12.96 Family$47.96$30.17$23.18 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 14
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Flexible Spending Accounts Annual Enrollment 2011
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Flexible Spending and Dependent Care Accounts Administration will remain with ConnectYourCare You must make a new election for the 2011 Plan Year; current elections cannot be carried forward Due to National Health Care Reform, as of January 1, 2011, over- the-counter (OTC) medicines are no longer eligible for purchase with an FSA unless you have a prescription from your doctor You can continue to use your FSA funds to purchase OTC items that are not considered a medicine or drug (e.g. bandages, splints, contact lens solutions, etc.) Take these new rules into consideration when estimating the dollar amount you will put in your FSA in the upcoming plan year S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 16
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Flexible Spending and Dependent Care Accounts Annual maximum for the health care FSA will remain at $5,000 Annual maximum for the Dependent Care Account Contribution will remain at $5,000 ($2,500 if married and filing separate returns) For the health care FSA, your total election amount less previous reimbursements is available at the time of transaction For the Dependent Care FSA, only the cash balance in your account is available at the time of transaction You cannot roll over unused balances from one year to the next; carefully estimate your expenses for the next plan year… especially in light of the new OTC rules S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 17
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Flexible Convenience Card Can be used at authorized vendors (medical facilities, hospitals, pharmacies, etc.) Allows direct payment at time of service If you have a prescription for an OTC medication, you must pay out-of-pocket (NOT with your FSA debit / convenience card) and submit a manual claim requesting reimbursement Cards are good for three years! So, if you currently have a Flexible Convenience Card, hold on to it! It will be reloaded with any election you make for 2011! S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 18
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Eligible Traditional Medical FSA Expenses Copays, co-insurance and deductibles for medical, prescription and dental plans Eye exams, contacts and eyeglasses Laser eye surgeries Hearing aids Over-the-counter medical supplies (but not medications) –Bandages, splints, contact lens solution, etc. Insulin Some expenses not covered by your health care plan S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 19
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Advantages of FSAs—Tax Savings Example Without FSA Pretax SavingsWith FSA Pretax Savings Annual Base Pay $25,000 Health Care Account Expenses -$0-$1,000 Dependent Care Account Expenses -$0-$2,000 Annual Taxable Income $25,000$22,000 Estimated Federal Income Taxes -$3,750-$3,300 After-tax Cost of Expenses -$3,000-$0 Annual Net Pay $18,250$18,700 Tax Savings $450 Assumes individual filer w/federal income tax rate of 15%; example does not include state, city, or other taxes S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 20
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Annual Enrollment 2011 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx
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Elections Are Binding For The Plan Year Unless There Is A Life Status Change Marriage Birth/adoption Divorce Death Change in employment status Change in dependent status Life status change allows you to make benefit election changes and adjust your FSA elections Benefits department must be notified within 31 days of life change S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 22
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What Next? Enrollment season is November 1 st through 30 th All employees must enroll or make changes through Banner Self- Service Update beneficiary information if necessary Return all materials to the benefits office no later than Tuesday, November 30 th, 2010 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 23
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