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OPEN ENROLLMENT 2012 BELLARMINE EMPLOYEES’ OPEN ENROLLEMENT 2013 Presented By: Laura Kuczenski 925-385-5305; laura@filice.comlaura@filice.com
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2 BENEFITS Medical Blue Shield of California Kaiser Dental – Assurant Vision – VSP Life/Disability – Sun Life Long Term Care – Unum FSA – Pension Dynamics HSA – Sterling
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3 WHAT IS OPEN ENROLLMENT? OPEN ENROLLMENT Open Enrollment is a once-a-year opportunity to make election changes Change plans Add or drop coverage for yourself Add or drop coverage for your dependents
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4 MID-YEAR QUALIFYING EVENTS What changes can I make outside of Open Enrollment? The only time you can make an election or enrollment change outside of your open enrollment period is if you experience an eligible qualifying event as defined by the IRS. Common examples of qualifying events include, but are not limited to, the following: Marriage Divorce or legal separation Birth or adoption Gain or loss of coverage OPEN ENROLLMENT
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5 IMPORTANT DATES MEDICAL COVERAGE 11/12/12 to 12/17/12 - Open enrollment 1/1/2013 – Your plan changes become effective 1/1/13 – 12/31/13 – The “Plan Year” IMPORTANT FACTS Deductibles and out of pocket maximums are the Plan Year (aka Calendar Year) Dependent children covered up to age 26 They are then COBRA eligible Opt-out medical incentive: $166.67 per month With proof of other medical coverage OPEN ENROLLMENT
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6 Largest nationwide network Not-for-profit organization 24/7 nurse line Access to free programs including MyHealth Coach, Future Moms, and more Can choose any doctor; however, in-network doctors will provide greater savings Email your doctor, online lab results Access to free programs including health management, weight loss support, quitting smoking Doctor must be in Kaiser community All Kaiser doctors have access to your medical records
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7 No plan changes; however, some carrier- mandated benefit changes Carriers required certain changes to plan designs across the board for all fully insured clients. Bellarmine did not have any say in the changes Selected Carrier Mandated changes highlighted in red This presentation is an overview. Complete “Benefit Modification” summaries can be found on the website MEDICAL RENEWAL
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8 Plan FeaturesIn-NetworkNon-Network Deductible Per Member Per Family Out of Pocket Max Per Member Per Family $0 $1,000 $3,000 $500 Maximum of 3 $3,000 $9,000 Preventive Care Routine exam, screenings$0Not covered Office / Specialist Visits$10 / $1030% Diagnostic Lab & X-ray$1030% Coinsurance 10%30% Hospital Services $200/day for 5 days30% Emergency Services$100 copay + 10% Prescription Medication Tier 1 Tier 2 Tier 3 Tier 4 $10 $20 $35 30% 25% of billed amount plus copays BLUE SHIELD – PREMIER PPO MEDICAL PLAN DESIGNS
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9 BLUE SHIELD – SPECTRUM PPO MEDICAL PLAN DESIGNS Plan FeaturesIn-NetworkNon-Network Deductible Per Member Per Family $500 $1,500 Out of Pocket Max Per Member Per Family $2,000 $6,000 $5,000 $15,000 Preventive Care Routine exam, screenings$0Not Covered Office Visits $15 30% Diagnostic Lab & X-ray $1530% Hospital Services 10%30% Emergency Services$100 + 10% after deductible Prescription Medication Tier 1 Tier 2 Tier 3 Tier 4 $10 $20 $35 30% 25% of billed amounts plus copays
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10 Plan FeaturesIn-NetworkNon-Network Deductible Per Member Per Family $2,250 $4,500 Out of Pocket Max Per Member Per Family $3,000 $6,000 $12,000 Preventive Care Routine exam, screenings$0Not Covered Office Visits20% after deductible 50% after deductible Diagnostic Lab & X-ray 20% after deductible 50% after deductible Hospital Services $100 + 20% after deductible 50% after deductible Emergency Services$100 + 20% after deductible Prescription Medication Tier 1 Tier 2 Tier 3 Tier 4 After deductible $10 $25 $40 30% After deductible 25% of billed amounts plus copays BLUE SHIELD – 2250/4500 HSA MEDICAL PLAN DESIGNS
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11 HSA BASICS WHAT IS AN HSA? Individual Tax-favored health savings account You own your account, and funds roll over each year – NO “use it or lose it” rules FSA has a “use it or lose it” policy WHO IS ELIGIBLE FOR AN HSA? Must be enrolled in qualifying High Deductible Health Plan such as Kaiser and Blue Shield HSA Not covered under any other health insurance Not enrolled in Medicare or receiving VA benefits Not another person’s dependent MAXIMUM CONTRIBUTIONS 2012: $3,100 individuals / $6,250 families 2013: $3,250 individuals / $6,450 families For Both Years: $1,000 “catch-up” contribution for individuals over 55 years of age
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12 HSA - STERLING STERLING HSA Employees must open an HSA account through Sterling to receive direct contributions from Bellarmine, and to set aside pre-tax dollars through payroll WHAT DOES THE COMPANY CONTRIBUTE? NO CHANGE FROM 2012 Blue Shield of CA HSA: Single: $242 Employee Family: $485 Kaiser HSA: Single: $900 Family: $1,800
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13 KAISER HMO $10 MEDICAL PLAN DESIGNS Plan FeaturesIn-Network Only Deductible Out of Pocket Max Per Member Per Family none $1,500 $3,000 Preventive Care Routine exam, screenings$0 Office Visits$10 Specialist Visits$10 Diagnostic Lab & X-ray No charge Hospital Services No charge Emergency Services$50 copay (waived if admitted) Prescription Medication Generic and Brand $10
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14 Plan FeaturesIn-Network Only Deductible Per Member Per Family $1,500 $3,000 Out of Pocket Max Per Member Per Family $1,500 $3,000 Preventive Care Routine exam, screenings$0 Office Visits0% after deductible Diagnostic Lab & X-ray 0% after deductible Hospital Services 0% after deductible Emergency Services0% after deductible Prescription Medication $0 after deductible KAISER – HSA MEDICAL PLAN DESIGNS
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15 NEW PREVENTIVE CARE GUIDELINES FOR WOMEN COVER THE FOLLOWING SERVICES (COVERED AT 100% WITHOUT COST SHARING) Well-women visits Gestational diabetes screening HPV DNA Testing for women 30 and older Sexually Transmitted infection counseling; HIV screening and counseling FDA approved contraception methods and counseling Breastfeeding support, supplies, and counseling Domestic Violence support, supplies, and counseling FOR ADDITIONAL DETAILS www.healthcare.gov/law/provisions/preventive/index.html www.healthcare.gov/law/provisions/preventive/index.html PREVENTIVE CARE FOR WOMEN
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16 DENTAL PLAN DESIGN DEDUCTIBLE $50 individual / $150 family COVERAGE (in-network/out-of-network) Diagnostic and Preventive (deductible waived): 100% / 100% Basic (ex: Fillings, simple extractions): 90% / 80% Major (ex: crowns, dentures): 60% / 50% Orthodontia: 50% (child-only) PLAN MAXIMUMS $1,000 calendar year max. per person $1,000 orthodontia lifetime max. BELLARMINE PAID DENTAL “ACTIVE” PPO
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17 VSP SIGNATURE NETWORK Only available to Blue Shield members Kaiser members have their own vision plan COPAYS $20 exam copay Lenses: $20 Copay Frames: Up to $120 + 20% of additional costs Contact Lenses: Up to $120 for contact and contact lens exam. SERVICE FREQUENCIES Exams: every 12 months Lenses (for glasses or contacts): every 24 months Frames: every 24 months BELLARMINE PAID VISION VISION PLAN DESIGN
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18 LIFE AND DISABILITY LIFE AND AD&D INSURANCE Insured by Sun Life Financial 2x Salary to $200,000 Benefits reduction: 65% at 70 years of age 50% at 74 years for age BELLARMINE PAID LONG TERM DISABILITY Insured by Sun Life Financial Benefit is 66.67% of pre-disability earning to $8,000 per month 90-day elimination period BELLARMINE PAID
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19 LONG-TERM CARE BASE PLAN Insured by Unum 3-year benefit duration $3,000 monthly facility benefit; 70% Residential Care facility $36,000 life-time benefit BELLARMINE PAID BUY UP OPTIONS – OUTSIDE OF INITIAL ELIGIBILITY Open to you and your family ALL buy-up requires medical questionnaire (See HR for the forms) Increase monthly benefit amount Increase lifetime maximum Increase benefit duration (6 years or unlimited) Add inflation protection EMPLOYEE PAID
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20 HEALTH CARE FSA – UP TO $2,500 ANNUALLY IRS CHANGED THE MAXIUM FROM $10,000 IN 2012 TO $2,500 IN 2013 LIMITED PURPOSE FSA – UP TO $2,500 ANNUALLY IRS CHANGED THE MAXIUM FROM $10,000 IN 2012 TO $2,500 IN 2013 DEPENDENT CARE FSA – UP TO $5,000 ANNUALLY FSAs help you pay eligible healthcare and dependent care expenses on a pre-tax basis (lowering your overall taxable income). If you are enrolled In The Anthem HMO, PPO, or Kaiser HMO, then you may enroll in a full FSA IF YOU HAVE AN HSA Account, you may only enroll in a Limited Purpose FSA (Dental and vision expenses) Dependent Care FSA is not affected by your medical plan USE-IT-OR-LOSE-IT RULE: UNUSED DOLLARS ARE NOT RETURNED TO YOU! FLEXIBLE SPENDING ACCOUNTS (FSA)
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21 Examples of Eligible Expenses Health CareLimited Purpose Hearing services, including hearing aids and Batteries Prescription and office visit copays Dental and orthodontia Dental and Orthodontia Hearing services not covered by your medical plan Lasik Surgery Other vision expenses Dependent Care The cost of child or adult dependent care (must be tax dependent) Nursery schools and preschools (excluding kindergarten) The cost for an individual to provide care either in or out of your house FLEXIBLE SPENDING ACCOUNTS
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22 CONTRIBUTION STRATEGY EMPLOYEE CONTRIBUTIONS BLUE SHIELD Premier PPO $0/$500 2012 EE/PP 2013 EE/PP 2012 EE Cost/Yr 2013 EE Cost/Yr Single Employee $168.22$177.04$4,037$4,249 Employee + 1 Dependent $463.55$485.33$11,125$11,648 Employee + Family (2 or more) $641.32$671.91$15,392$16,126 Numbers may vary due to rounding BLUE SHIELD Spectrum PPO $500/$1,000 2012 EE/PP 2013 EE/PP 2012 EE Cost/Yr 2013 EE Cost/Yr Single Employee $124.66$131.87$2,992$3,165 Employee + 1 Dependent $370.76$389.08$12,297$9,338 Employee + Family (2 or more) $508.02$533.66$12,192$12,808 Numbers may vary due to rounding BLUE SHIELD HSA $2,250/$4,500 2012 EE/PP 2013 EE/PP 2012 EE Cost/Yr 2013 EE Cost/Yr 2012 Paid by ER to HSA 2013 Paid by ER to HSA Single Employee $22.35$25.41$536$610$242 Employee + 1 Dependent $151.57$161.04$3,638$3,865$485 Employee + Family (2 or more) $184.31$197.20$4,423$4,733$485 Numbers may vary due to rounding
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23 EMPLOYEE CONTRIBUTIONS KAISER HMO $0 2012 EE/PP2013 EE/PP 2012 EE Cost/Yr 2013 EE Cost/Yr Single Employee$6.26$6.37$150$153 Employee + 1 Dependent $80.06$82.16$1,921$1,972 Employee + Family (2 or more) $77.58$79.58 $1,862$1,910 Numbers may vary due to rounding KAISER HSA $1,500/$3,000 2012 EE/PP 2013 EE/PP 2012 EE Cost/Yr 2013 EE Cost/Yr 2012 Paid by ER to HSA 2013 Paid by ER to HSA Single Employee $14.72$24.58$353$590$900 Employee + 1 Dependent $96.97$118.58$2,327$2,846$1,800 Employee + Family (2 or more) $70.39$99.95$1,689$2,399$1,800 Numbers may vary due to rounding CONTRIBUTION STRATEGY
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24 EMPLOYEE BENEFITS WEB PORTAL FILICE HAS DESIGNED A CUSTOMIZED WEBSITE THAT ALLOWS EMPLOYEES AND DEPENDENTS TO ACCESS INFORMATION AS NEEDED. Plan Overviews Physician Directories Group Numbers and Carrier Contact Information HR Forms and Required Postings Account Manager Contact Information www.filice.com/benefits/bcp OUR BROKER – FILICE INSURANCE
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25 All elections will automatically transfer. No action needed if you are not changing your medical; however: All medical waivers must be accompanied by a recent copy of your medical card to HR. Incentive payments will not begin until a copy of the medical card is received. FSA AND HSA BENEFITS MUST BE RENEWED WITH HR All changes must be made by December 17, 2012. All changes will go into effect January 1, 2013. WHAT NOW?
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26 OPEN ENROLLMENT INSTRUCTIONS OPEN ENROLLMENT BEGINS Monday, November 12, 2012 through December 17, 2012 You will be able to access your benefits and change them, if you desire, on the ADP website. Remember to reenroll in your Flexible Spending and HSA Accounts! To access your account: 1. Go to this URL: https://portal.adp.comhttps://portal.adp.com 2. Enter your User ID: (your first initial and last name)@bellarmine 3. Enter the password you created when you registered If you forgot your password, hit the “Forgot Password” and it will take you through the steps to setup a new password. If that doesn’t work, please contact Christine Carbone to help you get into the site. At the top you will see tabs. 1)Click on the “Benefits” tab 2)A dropdown menu will appear 3)Scroll down to “Review/Change Benefits” 4)You will then be asked to select one of the following: Walk me through the process I know what changes I want to make. Review my benefits coverage. 5)CONGRATULATIONS!! You are now in “Open Enrollment”. Make your desired changes now. 6)If you have any questions or need help, don’t hesitate to call (x228) or email Christine
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27 YOUR QUESTIONS? ? You can contact your Filice Account Manager: Laura Kuczenski laura@filice.com 925-385-5305
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