University of Cincinnati 2014 Open Enrollment *Information on the following pages may not apply to all employee groups. Humana of Ohio
Medical/Rx Benefits Did you know? 75% of all healthcare costs are a direct result of preventable chronic health conditions. The money you spend for healthcare is an investment in your health and your future. Finding the right health plan for you and your family is an important first step. 2
Q How will you and your family use healthcare services? Q How much do you spend to purchase benefits each year? Q How much do you pay out of pocket to receive services? Questions to Ask During Open Enrollment 3 A Annual preventive check-ups only or managing a condition that requires expensive Rx or Hospital services? A Paycheck contributions are the Up- Front cost of health insurance. A Co-payments, Deductibles and Coinsurance are the Pay-as-you-go costs.
University of Cincinnati 2014 Medical Benefit Offering What’s Staying the Same? You will continue to be offered the Point of Service Plan Plan (NPOS) with minimal change What’s Changing for January 1, 2014? You will be offered a High Deductible Health Plan (HDHP) that comes with a Health Savings Account (HSA) You will No Longer be Offered an HMO You will No Longer be Offered First 1000
The Benefits of an NPOS Plan 5 Benefits of NPOS Plan: Flexibility to choose your doctors, hospitals, and other healthcare providers Potential higher “upfront” premium, lower “pay as you go” cost National Point of Service (NPOS) plan: Comprehensive coverage Caps on out-of-pocket spending in a plan year Lower costs when you use in-network providers
6 2014 POS Plan Design In-Network20142013 Preventive Care100% PCP Physician Visit100% after $15 copay Specialist Visit100% after $20 copay Urgent Care100% after $20 copay Emergency Room100% after $75 copay Test/Lab/DME90% after deductible100% after deductible Outpatient90% after deductible100% after deductible Inpatient90% after deductible100% after deductible Deductible$100 individual/ $200 family Max Out-of-Pocket$1100 individual/ $2200 family Prescription Drugs$15/$25/$35/25% coinsurance RightSource Mail Order$30/$50/$75/25% coinsurance
High Deductible Health Plan (HDHP) 7 No copayment for office visits or prescriptions All covered medical and prescription expenses go toward the same integrated deductible Plan covers expenses at the coinsurance level after deductible: 90 percent in-network 70 percent out-of-network Compatible with Health Savings Account (HSA) Components of the HDHP Preventive Services covered at 100 percent Upfront deductible Coinsurance coverage up to maximum annual out-of-pocket Member may use Health Savings Account to cover the member cost-share Security and peace of mind by limiting Maximum Out-of-pocket
Copayments (In Network) (Out-of-Network) HDHP 1500 90/70In-NetworkOut-of-Network Preventive Care100%70% after deductible Physician / Specialist90% after deductible70% after deductible Urgent Care90% after deductible70% after deductible Emergency Room90% after deductible70% after deductible Outpatient90% after deductible70% after deductible Inpatient90% after deductible70% after deductible Prescription Drugs90% after deductible70% after deductible Employee Only Deductible$1,500$3,000 Max Out of Pocket$3000$6,000 Family of 2 or more Deductible$3,000$6,000 Max Out of Pocket$6,000$12,000 High Deductible Health Plan (HDHP)
What is a Health Savings Account? 9 A Health Savings Account, or HSA, is a tax-free account that… helps you budget for health care expenses this year. allows you to build savings for future expenses. is available only if you are enrolled in a High Deductible Health Plan. An HSA comes with rules that you must follow… The HDHP must be your only medical coverage. You cannot be Enrolled in Medicare benefits If you are claimed as a dependent on another person’s tax return (doesn’t include spouses) you cannot have an HSA.
The HDHP and the HSA work together 10 High Deductible Health Plan You are responsible for your covered medical and prescription drug costs until you meet your deductible. Once you meet your maximum out of pocket limit the plan pays 100 percent for covered services from participating providers. Health Savings Account Use HSA funds to pay expenses prior to meeting the deductible or you can pay another way and leave the money in your HSA. Once money goes into the HSA it’s yours forever. Unused money carries over from year to year with no maximum balance
The HSA and Other Expenses Use your HSA for other IRS-approved expenses that are not covered by your medical plan: Dental expenses and orthodontia expenses Vision care including eyeglasses, contact lenses and laser surgery Eligible over-the-counter drugs with a prescription Premiums for COBRA, Long Term Care, Medicare and more…
Where does the HSA money come from? 12 UC contributes to your HSA $350 - $800 Employee Only (based upon Salary) $700 – $1,600 Family (based upon Salary) You can contribute tax free from your paycheck* Maximum Total Contribution for 2014 (UC $ + Employee $) $3,300 Single $6,550 Family Age 55 or older - $1,000 "catch-up" contribution * Payroll deductions, up to the IRS-allowed maximum, aren’t subject to federal taxes and are tax-free in most states, too. AL, CA, NJ and WI do not presently permit deductions and tax free gains. Interest and investment earnings are tax free
2014 Health Savings Account UC Funding (annual) 13 Health Savings Account Funding - Based on Annual Base Pay Less than $40,000 $40,000 - $79,999 $80,000- $99,000 $100,000 + Employee$800$550$450$350 EE + 1$1600$1100$900$700 Family$1600$1100$900$700 Employee Only Deductible: $1500 Employee + One OR Family Coverage Deductible: $3000
Spending your HSA money 14 You’ll receive a HumanaAccess HSA Visa ® card from UMB Use the card for eligible expenses at doctor’s offices, hospitals, and pharmacies by swiping the card or writing the account number on a bill If a provider doesn’t take Visa, request a reimbursement from your HSA or transfer from your HSA to your checking account through MyHumana on www.humana.com. www.humana.com Remember! You can only spend money that’s in your HSA. If an expense exceeds your account balance, pay another way and get reimbursed when money is in your HSA. Spend your money on eligible items only. If you use HSA funds for ineligible items, you’ll pay an IRS penalty, plus taxes on the amount you spent Always save your receipts the IRS may ask for proof your expense was eligible
2014 Monthly Employee Contributions 15 Less than $40,000 $40,000 - $79,999 $80,000- $99,999 $100,000 + Employee$121$128$136$151 EE + 1$242$255$272$301 Family$356$377$400$445 POS Plan Cost – Based on Annual Base Pay HDHP Plan Cost – Based on Annual Base Pay Less than $40,000 $40,000 - $79,999 $80,000- $99,999 $100,000 + Employee$47$50$53$59 EE + 1$94$100$106$118 Family$139$147$157$174
2014 Enrollment Process 16 To prepare for Open Enrollment please Register at www.humana.com Your password-protected MyHumana personal page offers a wealth of information including: Your Personal Medical and Rx Claims History In-Network Provider Search Prescription Tools including Cost Information on Humana Discounts
2014 Enrollment Process 17 PLEASE MAKE NOTE: Due to the 2014 New Plan Offerings, every UC Employee must actively re-enroll during Open Enrollment to maintain benefits into the 2014 Plan Year. Mark Your Calendars!! UC’s Open Enrollment Period will be: November 1-30, 2013 You will have an opportunity to meet 1 on 1 with a Benefit Counselor during Open Enrollment Dates, Times and Locations will soon be announced.