Download presentation
Presentation is loading. Please wait.
Published byRegina Chandler Modified over 9 years ago
1
School Board of Highlands County -Insurance Update for 2013- 1
2
2 Step 2 Your Contribution Single $1,000 Family $2,000 (your responsibility) Step 1 Base Health Reimbursement Arrangement (HRA) Fund* SBHC Single $1,000 Family $2,000 Step 3 Health Plan In-Network CIGNA pays 80% You pay 20% Preventive Care covered 100% (In-Network Only) Step 1 + Step 2 Deductible Single $2,000 Family $4,000 Review - Components of HRA Health Plan IMPORTANT NOTES: 1.HRA fund available for Medical Claims and Pharmacy Claims. 2.Unused funds will ROLLOVER from previous year. 3.Out-of-Pocket Maximum includes Deductible Step 4 Out-of-Pocket Maximum Single $5,000 Family $10,000 (100% medical coverage) HRA Plan
3
3 CIGNA Health Plan Improvements/Changes for the 2013 Plan Year: The HRA fund increases: From $750 to $1,000 for Single coverage From $1,500 to $2,000 for Family coverage The deductible reduces: From $2,500 to $2,000 for Single coverage From $5,000 to $4,000 for Family coverage The current Buy-Up plan will discontinue on 12/31/12
4
HRA Fund & Deductibles Compared Renewal Deductible -$2,000 Renewal HRA Fund Pays -$1,000 Deductible -$5,000 HRA Fund Pays -$1,500 Renewal Deductible -$4,000 Renewal HRA Fund Pays -$2,000 Single Plan Family Plan Current Year 2013 Deductible -$2,500 HRA Fund Pays -$750 4
5
What will remain the same: Plan structure remains the same (i.e. preventive care, coinsurance, lab work and x-ray benefits, etc.) The dependent coverage deductions will remain the same The Out-of-Pocket Maximum remains the same; $5,000/Single and $10,000/Family Employees will continue to be required to complete the Health Assessment with biometric data to be covered by the Health Insurance Plan 5
6
6 Preventive Care – Know Your Numbers! Schedule your annual physical – wellness exam – Post Card Reminders were mailed first week of July – Annual Wellness Exam is covered by Cigna at 100% if a Network Provider is used Know Your Numbers! Ask your doctor for your results of your associated preventive care lab work: Total Cholesterol HDL Cholesterol Blood Pressure – Systolic/Diastolic Height Weight Waist Circumference
7
Health Assessment Campaign Employees are to take their annual Health Assessment online at www.mycigna.com between 8/1/12 – 9/30/12www.mycigna.com Computer Lab Hours – Available if anyone needs a computer or assistance Each Monday in August and September at the District Office 3:00-6:00 with the exception of 9/3/12 which is a Holiday. 7
8
Flexible Spending Account (FSA) - Optional Employee enrolls during Open Enrollment and elects an annual amount for their FSA account. Contributions are made as a payroll deduction in equal amounts each pay period (2013 Health Care FSA annual max. = $2,500) FSA account reimburses the employee for out-of-pocket expenses incurred in that plan year via reimbursement requests sent to CIS, once the HRA fund is expended Employee can be reimbursed for eligible out-of-pocket health/dental expenses up to their annual elected amount, before the full contributions have been made Plan annual amount carefully based on known medical expenses to be incurred in the calendar year. If all account contributions are not used (reimbursed), remaining contributions are forfeited. Employee receives tax advantage because FSA contributions reduce taxable income Employee enrolls during Open Enrollment and elects an annual amount for their FSA account. Contributions are made as a payroll deduction in equal amounts each pay period (2013 Health Care FSA annual max. = $2,500) FSA account reimburses the employee for out-of-pocket expenses incurred in that plan year via reimbursement requests sent to CIS, once the HRA fund is expended Employee can be reimbursed for eligible out-of-pocket health/dental expenses up to their annual elected amount, before the full contributions have been made Plan annual amount carefully based on known medical expenses to be incurred in the calendar year. If all account contributions are not used (reimbursed), remaining contributions are forfeited. Employee receives tax advantage because FSA contributions reduce taxable income 8
9
Employee w/ Single – Health Plan Coverage DeductibleEmployer Paid HRA Fund Out-of-Pocket to Meet Deductible (Expense Gap) # of Paychecks per Year Per-Paycheck Contribution 24-Pay Employee $2,000- $1,000= $1,000÷ 24= $41.67 20-Pay Employee $2,000- $1,000= $1,000÷ 20= $50.00 Employee w/ Family – Health Plan Coverage DeductibleEmployer Paid HRA Fund Out-of-Pocket to Meet Deductible (Expense Gap) # of Paychecks per Year Per-Paycheck Contribution 24-Pay Employee $4,000- $2,000= $2,000÷ 24= $83.33 20-Pay Employee $4,000- $2,000= $2,000÷ 20= $100.00 Bridging the ‘Expense Gap’ with an FSA When the HRA fund is expended, employee pays medical/pharmacy costs out-of-pocket until deductible is met. Once the deductible is met, coinsurance benefits apply and prescription costs are reduced: CoinsurancePrescriptions (Retail) Employee Pays 20% Generic - $15 Preferred Brand – 40% (Min: $20, Max: $50) Non-Preferred Brand – 50% (Min: $40, Max: $100) 9
Similar presentations
© 2024 SlidePlayer.com. Inc.
All rights reserved.