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2008 BENEFITS OVERVIEW Employee Presentation. AETNA Benefits Offering Overview Multiple Medical Plans: HSA, HRA, HMO, PPO Multiple Medical Plans: HSA,

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Presentation on theme: "2008 BENEFITS OVERVIEW Employee Presentation. AETNA Benefits Offering Overview Multiple Medical Plans: HSA, HRA, HMO, PPO Multiple Medical Plans: HSA,"— Presentation transcript:

1 2008 BENEFITS OVERVIEW Employee Presentation

2 AETNA Benefits Offering Overview Multiple Medical Plans: HSA, HRA, HMO, PPO Multiple Medical Plans: HSA, HRA, HMO, PPO Choice of Two Dental Plans: Dental PPO or Dental Choice of Two Dental Plans: Dental PPO or Dental Maintenance Organization – DMO (available in some Maintenance Organization – DMO (available in some areas) areas) Supplemental Life Insurance for Employee, Spouse Supplemental Life Insurance for Employee, Spouse & Children & Children New 01/01/08 – During the 90 day benefit waiting period New 01/01/08 – During the 90 day benefit waiting period staff & contractor core benefit eligible employees staff & contractor core benefit eligible employees will be eligible for a limited medical (mini-med) will be eligible for a limited medical (mini-med) plan (SRC) plan (SRC)

3 Whats the Difference Between Coinsurance and Copay? Coinsurance is the percentage of covered expenses paid by the health insurance plan after the deductible is met. This percentage varies depending on the plan design In this example, a health insurance plan covers 80% (in- network) of medical expenses after the deductible is met The member pays the remaining 20% A copayment is a fixed-dollar amount paid for covered medical expenses HRA 5, 12/06 Doctor Bills $100 Member Pays $20 (or 20% coinsurance) Health Ins. Plan pays $80 (or 80% coinsurance) ]

4 What is a Consumer-Directed Health Plan? HRA 5, 12/06 ] Why does PDS advocate consumer driven healthcare? Why does PDS advocate consumer driven healthcare? Informed consumers make better decisions. Lower spending leads to lower premium increases. Consumer-directed health plans, or CDHPs, are made up of three elements: An underlying deductible-based health insurance plan A fund or account that you can use to help pay for qualified, out-of-pocket medical expenses Interactive tools and information to help you make informed health care decisions

5 How Do Consumer-Directed Health Plans Work? Preventive Care Covered at 100% All Other Care Health care FUND for out-of-pocket medical expenses 1 2 You pay medical expenses until you meet DEDUCTIBLE 3 Underlying insurance plan provides coverage with COINSURANCE or COPAY Out of Pocket MaximumInformation and Decision Support Tools

6 HSA – Health Savings Account The plan includes two components, the underlying medical The plan includes two components, the underlying medical plan, and a Health Savings Account plan, and a Health Savings Account The underlying medical plan is deductible based, therefore The underlying medical plan is deductible based, therefore the deductible must be satisfied before any expenses are the deductible must be satisfied before any expenses are payable, with the exception of preventative payable, with the exception of preventative Once the deductible is satisfied a percentage of expenses are Once the deductible is satisfied a percentage of expenses are paid by the plan paid by the plan $2,500 ee/$5,000 family – In Network $2,500 ee/$5,000 family – In Network $3,000 ee/$6,000 family – Out-of-Network $3,000 ee/$6,000 family – Out-of-Network The provider network for the HSA is the same as the PPO plan The provider network for the HSA is the same as the PPO plan The second component of the plan, is an account that you The second component of the plan, is an account that you can use to help pay for qualified out-of-pocket expenses can use to help pay for qualified out-of-pocket expenses Long-term investment options Long-term investment options Unused account balances roll over year-to-year Unused account balances roll over year-to-year The account is yours to keep even if you change employers The account is yours to keep even if you change employers or medical plans or medical plans You determine how & when your Health Savings Account You determine how & when your Health Savings Account dollars are used dollars are used

7 How does a Health Savings Account (HSA) Work? Health Savings Account Contribute tax free Reimburse qualified expenses tax free Save for future expenses Grow the account with interest and/or choose the HSA investment services offered Medical and Prescription Drug Plan Benefits Preventive care covered at 100% Meet the plan deductible), then Pay coinsurance Out-of-pocket maximum limits amount you pay annually Manage Your Health Care Secure, personalized online services Track HSA activity, monitor savings Find a doctor, estimate cost of care, compare hospitals Research health topics and medications

8 How Much May I Contribute to my HSA? 2008 annual maximum 2008 annual maximum $2,900 per individual $2,900 per individual $5,800 per family $5,800 per family Catch Up Contributions Catch Up Contributions Individuals age 55 to 64 Individuals age 55 to 64 $900 for 2008 $900 for 2008 Amount increases $100 per year until 2009 Amount increases $100 per year until 2009 If age 65+ and enrolled in Medicare Part A or B If age 65+ and enrolled in Medicare Part A or B HSA may remain open HSA may remain open No additional contributions can be made No additional contributions can be made

9 The Value of Tax-Advantaged HSA Savings* Over Time Annual Contribution Amounts Tom, Age 39 $1,000$2,000$3,000 Total Savings for Future Medical Expenses** (at age 65) $34,343$68,687$103,032 Annual Tax Savings $330$660$990 Accumulated Tax Savings (at age 65) $8,580$17,160$25,740 *Employers and employees should consult with a tax advisor to determine eligibility requirements and tax advantages associated with participating in the Aetna HealthFund HSA plan. **Based on an estimated 2 percent investment rate of return each year. Assumes member is in the HSA for an entire year and contributing up until the age selected (65) and that the contribution rate and interest rate selected remain constant until the age that the member stops contributing.

10 HRA – Health Reimbursement Account The plan pays the first $500 (ee only) or $1,000 (family) The plan pays the first $500 (ee only) or $1,000 (family) covered expenses at 100% covered expenses at 100% Any remaining fund amounts ($500/$1,000) can be Any remaining fund amounts ($500/$1,000) can be rolled over to the next plan year rolled over to the next plan year Once the health fund is exhausted, you will need to Once the health fund is exhausted, you will need to satisfy a deductible satisfy a deductible $3,000 ee/$6,000 family – In Network $3,000 ee/$6,000 family – In Network $6,000 ee/$12,000 family – Out of Network $6,000 ee/$12,000 family – Out of Network Expenses paid by your health fund also reduce the Expenses paid by your health fund also reduce the deductible deductible Preventative services payable at 100%. The health fund and Preventative services payable at 100%. The health fund and and deductible is waived. and deductible is waived. Plan uses the same provider network as the PPO plan Plan uses the same provider network as the PPO plan You determine how & when your health fund dollars are used. You determine how & when your health fund dollars are used. Unused health fund balance is forfeited when you move to Unused health fund balance is forfeited when you move to another plan or terminate employment another plan or terminate employment

11 How Does a Health Reimbursement Account (HRA) Work? HRA 5, 12/06 ] The Fund Use your employer-provided fund to pay for eligible medical expenses. Rollover: Unused fund balance rolls over to next years fund balance. The Deductible If the fund is exhausted, you pay for the remaining or future expenses until your deductible is met. The Base Insurance Plan If the fund is exhausted and the deductible met, your base insurance plan begins to pay toward covered expenses. You pay a coinsurance amount for eligible expenses.

12 HMO – Health Maintenance Organization (Not available in all locations) Selection of a Primary Care Provider (PCP) is required. Your PCP will manage your overall care. Selection of a Primary Care Provider (PCP) is required. Your PCP will manage your overall care. The plan does not have a deductible The plan does not have a deductible You pay a fixed dollar co-pay for office visits & preventative care You pay a fixed dollar co-pay for office visits & preventative care A referral from your PCP is required for services not provided by the PCP A referral from your PCP is required for services not provided by the PCP There is no out-of-network coverage There is no out-of-network coverage You will pay a higher premium to have a flat dollar co-pay for office visits You will pay a higher premium to have a flat dollar co-pay for office visits

13 PPO – Preferred Provider Organization You pay a fixed dollar co-pay for office visits & preventative care You pay a fixed dollar co-pay for office visits & preventative care You must satisfy the deductible before any expenses, other than office visits are payable You must satisfy the deductible before any expenses, other than office visits are payable Plan includes out of network coverage, at reduced reimbursement Plan includes out of network coverage, at reduced reimbursement The most expensive premium for the least amount of benefits The most expensive premium for the least amount of benefits

14 Open Enrollment Tools and Support Aetna Navigator, Your Secure Personal Website… www.aetnanavigator.com www.aetnanavigator.com Take a tour of the websites key features Take a tour of the websites key features Estimate the Cost of Care Suite of Tools Estimate the Cost of Care Suite of Tools Health Information on conditions & alternative options Health Information on conditions & alternative options Quality of participating providers Quality of participating providers 24 x 7 availability 24 x 7 availability Online Tutorials HSA and HRA plans HSA and HRA plans HSA Savings Calculator Explore the savings potential of an HSA Explore the savings potential of an HSA

15 NEW FOR 01/01/08 SRC – LIMITED MEDICAL PLANS Staff & core benefit eligible employees will be eligible for Staff & core benefit eligible employees will be eligible for SRC during the 90-day probationary period SRC during the 90-day probationary period There are two plan options available, $5,000 or There are two plan options available, $5,000 or $10,000 plan maximum $10,000 plan maximum The plan provides limited coverage for office visits, The plan provides limited coverage for office visits, pharmacy expenses, hospital services pharmacy expenses, hospital services Access to Aetnas negotiated provider discounts usually Access to Aetnas negotiated provider discounts usually discounts average 40% - 60%) discounts average 40% - 60%) Provides employees a low cost alternative other than Provides employees a low cost alternative other than continuing COBRA coverage during benefit waiting period continuing COBRA coverage during benefit waiting period

16 2008 Plan Design Changes HSA – No changes HSA – No changes HRA – No changes HRA – No changes HMO HMO PCP - $40, Specialist $50 Co-pays PCP - $40, Specialist $50 Co-pays Rx - $15/$20/50% Rx - $15/$20/50% Inpatient & Outpatient Co-insurance – 70%/30% Inpatient & Outpatient Co-insurance – 70%/30% PPO PPO Inpatient Co-insurance – 70%/30% Inpatient Co-insurance – 70%/30% Outpatient Co-insurance – 50%/50% Outpatient Co-insurance – 50%/50%

17 2008 Open Enrollment October 22 – November 4 October 22 – November 4 www.pdstech.com/benefits2008.com www.pdstech.com/benefits2008.com www.pdstech.com/benefits2008.com No password required No password required Plan Designs Plan Designs Tutorials – Aetna Navigator, HSA and HRA Plans, Printing ID Cards, etc. Tutorials – Aetna Navigator, HSA and HRA Plans, Printing ID Cards, etc. www.pdstech.essbenefits.com www.pdstech.essbenefits.com www.pdstech.essbenefits.com Requires social security # and password Requires social security # and password SSN entered as numerals only SSN entered as numerals only Password is reset to MMYY of date of birth Password is reset to MMYY of date of birth Print confirmation statements online Print confirmation statements online No mailing of confirmation statements No mailing of confirmation statements

18 Open Enrollment Questions PDS Benefits Website PDS Benefits Website Julie Barton – ext 10135 Julie Barton – ext 10135 Lorri Bloom – ext 10132 Lorri Bloom – ext 10132 Jathan Van Winkle ext 10145 Jathan Van Winkle ext 10145

19 Benefits Websites Aetna – www.aetna.com Aetna – www.aetna.comwww.aetna.com VSP – Vision Service Plan - www.vsp.com VSP – Vision Service Plan - www.vsp.comwww.vsp.com Hyatt Legal – www.legalplans.com Hyatt Legal – www.legalplans.comwww.legalplans.com Personal Care – www.personalcare.org Personal Care – www.personalcare.orgwww.personalcare.org


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