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Wells Fargo Insurance Services Los Angeles Community College District Presented by: Liliana Salazar, Esq., Vice President of Compliance Gary Delaney, CEBS, Senior Vice President Kristin Yokoyama, Account Director March 17, 2009 Wells Fargo Insurance Services Confidential. © 2008 Wells Fargo Insurance Services. All rights reserved.
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Wells Fargo Insurance Services 2 Agenda I. Health Reimbursement Arrangements (HRAs) ● Overview ● Funding II. Questions
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Wells Fargo Insurance Services 3 Health Reimbursement Arrangements (HRAs) HRAs are a benefit plan funded exclusively with employer contributions for the purpose of reimbursing employees’ present and/or future qualified health care expenses. General Provisions Eligible Participants are defined as active and former employees and their dependents (IRS Section 152) HRAs cannot be funded with employee contributions Contributions are usually made on an annual basis and are available to employees as of the 1 st day of the plan year Rollover Features Unused amounts can be rolled over from one year to the next. HRA funds do not accrue interest. HRA funds are not portable, they are part of the employer’s general assets. HRAs can become available to an employee once they retire
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Wells Fargo Insurance Services 4 Contributions to HRAs Contributions are made solely by an employer. The employer must contribute the same amount to employees eligible for the HRA (same contribution for all employees participating in CalPERS Plans) Employer contributions into HRAs are not treated as gross income. Catch-up contributions are not available (regardless of employee’s age) No cash disbursements are allowed Distributions (Reimbursement) from a HRA For Active Employees: HRA will reimburse medical, dental, and vision deductibles and out-of-pocket expenses For Retired Employees: HRA will reimburse medical, dental and vision deductibles and out-of-pocket expenses in addition to: Qualified Long Term Care Premiums Medicare Premiums (Parts A, B, D) Health Reimbursement Arrangements (HRAs)
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Wells Fargo Insurance Services 5 Example of Annual HRA Funding Amount*: Annual PPO out-of-pocket maximum with PERS Choice is $3000 Individual and $6000 Family Annual Deductible $500 Individual and $1000 Family District funds same amount for all active and early retiree enrollees (PPO or HMO) Using $5,000,000 of $15,000,000 projected annual savings to fund HRA Hypothetical HRA contribution funded by the District-$1,000 for each active and early retiree enrolled regardless of their tier of coverage Account “funded” at beginning of each plan year by LACCD Unused amounts rollover from one year to the next – can be used by employees upon retirement to pay for out-of-pocket healthcare expenses *Based on CalPERS financial analysis Health Reimbursement Arrangements (HRAs)
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Wells Fargo Insurance Services 6 Hypothetical Hospital Claim with PERS Choice PPO Plan PERS Choice Max. Annual Out-of-Pocket $ 3,000 PPO Annual Deductible$ 500 Hospital Retail Charges$50,000 Hospital charges after PPO discount$15,000 Deductible Applied to Charges $ 500 Balance$14,500 Employee’s copayment responsibility $ 2,900 20% of allowable amount until max. copayment is met Total paid by insurance carrier$11,500 Total paid by member $ 3,400 Health Reimbursement Arrangements (HRAs)
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Wells Fargo Insurance Services 7 Recommendations for HRA Design Equal contribution for employees in HMO and PPO plans (including PERS Care) Equal contribution for all tiers of coverage (single/family) Employees retiring from the District would be allowed to access the amounts in their HRA to pay for their out-of-pocket medical expenses as well as long term care and Medicare premiums. No additional contributions would be made by the District to a retiree’s HRA once the retiree becomes eligible for Medicare A third party administrator should be assigned to administer the HRA Health Reimbursement Arrangements (HRAs)
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Wells Fargo Insurance Services 8 QUESTIONS
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