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Employee Presentation

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Presentation on theme: "Employee Presentation"— Presentation transcript:

1 Employee Presentation
2008 BENEFITS OVERVIEW Employee Presentation

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

3 What’s 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% Health Ins. Plan pays $80 (or 80% coinsurance) Doctor Bills $100 Member Pays $20 (or 20% coinsurance) A copayment is a fixed-dollar amount paid for covered medical expenses ] HRA 5, 12/06

4 What is a Consumer-Directed Health Plan?
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 ] HRA 5, 12/06

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 Maximum Information and Decision Support Tools

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

7 How does a Health Savings Account (HSA) Work?
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 $2,900 per individual $5,800 per family Catch Up Contributions Individuals age 55 to 64 $900 for 2008 Amount increases $100 per year until 2009 If age 65+ and enrolled in Medicare Part A or B HSA may remain open 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) covered expenses at 100% Any remaining fund amounts ($500/$1,000) can be rolled over to the next plan year Once the health fund is exhausted, you will need to satisfy a deductible $3,000 ee/$6,000 family – In Network $6,000 ee/$12,000 family – Out of Network Expenses paid by your health fund also reduce the deductible Preventative services payable at 100%. The health fund and and deductible is waived. Plan uses the same provider network as the PPO plan You determine how & when your health fund dollars are used. Unused health fund balance is forfeited when you move to another plan or terminate employment

11 How Does a Health Reimbursement Account (HRA) Work?
The Fund Use your employer-provided fund to pay for eligible medical expenses. Rollover: Unused fund balance rolls over to next year’s 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. ] HRA 5, 12/06

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. The plan does not have a deductible 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 There is no out-of-network coverage 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 must satisfy the deductible before any expenses, other than office visits are payable Plan includes out of network coverage, at reduced reimbursement 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 Take a tour of the website’s key features Estimate the Cost of Care Suite of Tools Health Information on conditions & alternative options Quality of participating providers 24 x 7 availability Online Tutorials HSA and HRA plans HSA Savings Calculator 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 SRC during the 90-day probationary period There are two plan options available, $5,000 or $10,000 plan maximum The plan provides limited coverage for office visits, pharmacy expenses, hospital services Access to Aetna’s negotiated provider discounts usually discounts average 40% - 60%) Provides employee’s a low cost alternative other than continuing COBRA coverage during benefit waiting period

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

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

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

19 Benefits Websites Aetna – VSP – Vision Service Plan - Hyatt Legal – Personal Care –


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