Presentation on theme: "Antioch University Open Enrollment Presentation November, 2010."— Presentation transcript:
Antioch University Open Enrollment Presentation November, 2010
2 Medical Benefits - What are my options? Benefit options for 2011: 1. Anthem PPO Plan 2. Anthem Lumenos Health Savings Account (HSA)
3 Your 2011 Anthem PPO Plan PPO Medical BenefitsNetwork Benefits Deductible$400/$800 Coinsurance85% Plan, 15% Member Out of Pocket Maximum$800/$1,600 Office Visits$20 copay Preventive Care, not Diagnostic $20 copay Emergency Room$75 Urgent Care$75 All Other Covered ExpensesDeductible + 15% These benefits denote in-network coverage. Please refer to the complete benefit summary for out-of-network benefits and other benefit details which differ from the amounts noted above.
4 Your 2011 Anthem PPO Plan PPO Prescription Benefits Retail Tier 1$10 copay Tier 2$30 copay Tier 3$40 copay Mail Tier 1$20 copay Tier 2$50 copay Tier 3$70 copay
5 HSA – How It Works Health Savings Account Plan High Deductible Insurance Health Savings Account + Protects you from big Medical bills Helps pay your deductible Tax-deductible deposits Tax-deferred growth Tax-free for medical care
6 Opening Your Health Savings Account n Banks, credit unions, insurance companies and other financial institutions are permitted to be trustees or custodians of these accounts. YOU MUST OPEN YOUR OWN HSA ACCOUNT to deposit your HSA Contributions. Account should be open before 1/1/2011. n If you cannot locate a local institution willing to establish your account, try visiting a link recommended by the U.S. Department of the Treasury.
7 HSA – Who can not have one? n Anyone can enroll in the HSA plan, but you can not open the HSA bank account if you are: ─ Enrolled in Medicare ─ Enrolled in any other health plan that is not an HSA compatible health plan ─ Active in the military ─ Claimed as a dependent on another individual’s tax return n The IRS has specific rules on who can open an HSA.
8 HSA Eligible Expenses n The IRS determines which health care services are eligible for reimbursement by your HSA, up to $3,050 single and $6,150 family. Examples of eligible expenses are: ─ Medical services applied to your deductible or out of pocket maximum under your Anthem HSA plan ─ OTC medications with a prescription ─ Dental expenses ─ Vision Expenses (Medical expenses incurred by or on behalf of domestic partners or their children are ineligible for tax-free reimbursement from an HSA, unless the domestic partner qualifies as a dependent under IRC section 152.) n A Limited Purpose FSA can be set up for dental or vision expenses not reimbursed through HSA. Infrequently selected, this option is normally chosen when high-dollar expenses are being expected (braces, laser vision correction) and plan members want to protect their HSA dollars.
9 HSA Contributions n Antioch University - Annual Contributions: * January: $300 Contribution, April – December: $100/mo. ** January: $600 Contribution, April – December: $200/mo. n 2011 Annual HSA Contribution Maximums (includes Antioch University Contributions): ─ Single: $3,050 ─ Family: $6,150 n Catch Up Provision for those that are 55+ is $1,000 for Employee$1,200* Employee + 1$2,400** Employee + 2 or More$2,400**
10 Your 2011 Anthem HSA Plan HSA Medical BenefitsNetwork Benefits Deductible$2,500/$5,000 Coinsurance100% Plan, 0% Member Out of Pocket Maximum After deductible is met, rx copays apply $3,500/$7,000 Office VisitsDeductible + 0% Preventive Care, not Diagnostic 100%, no Deductible Emergency RoomDeductible + 0% Urgent CareDeductible + 0% All Other Covered ExpensesDeductible + 0% Enrolling in this plan gives you the opportunity to open a Health Savings Account (HSA) and enjoy lower payroll contributions
11 Your 2011 Anthem HSA Plan HSA Prescription Benefits Retail Tier 1$10 copay Tier 2$30 copay Tier 3$50 copay 30 Day Supply Tier 425% up to $150 maximum Mail Tier 1$10 copay Tier 2$75 copay Tier 3$150 copay 30 Day Supply Tier 425% up to $150 maximum After deductible is met, the following copays apply for all prescriptions until your copays equal $1,000 (single) and $2,000 (family) out of pocket.
12 Health Savings Account – IRS Limits for 2011 SingleFamilyCoverage Annual HSA Contribution Max $3,050$6,150 These limits apply to the combined employer and employee contributions Limited Purpose FSA Contribution Max $4,000 $4,000 Catch-Up Contribution $1,000$1,000 Allowed if age 55 +
13 Earn Rewards – HSA Participants Only n Earn gift card reward dollars for activities that contribute to your health and well-being: u $50 for completing the online MyHealth Assessment (one per family) u $100 for enrolling in a health coaching program for an eligible condition (per qualified family member) u $200 for graduating from a health coaching program for an eligible condition (per qualified family member) u $50 for completing the Healthy Lifestyles: Tobacco-Free Program (per qualified employee and/or spouse) u $50 for completing the Healthy Lifestyles: Healthy Weight Program (per qualified employee and/or spouse)
14 Redeem Rewards – HSA Participants Only Redeem your rewards dollars for gift cards to select health-focused retailers like: u Dick’s Sporting Goods u Foot Locker u The Athlete’s Foot u City Sports u And More The process is simple: 1. Earn your reward dollars 2. Receive a letter from IncentOne, which includes a code and password and instructions for redeeming your gift card reward online or by phone 3. Select from available retailers and redeem your gift card reward 4. Receive your gift card by mail
15 Two Fundamental Questions 1. How much do I have to pay out of my pocket when I use the health insurance plan? 2. How much does the health insurance plan cost out of my paycheck?
16 How much do I pay when I use the insurance? Network Medical BenefitsPPOHSA Deductible$400/$800$2,500/$5,000 Coinsurance15%0% Out of Pocket Maximum After Antioch HSA Contribution $800/$1,600$3,500/$7,000 $2,300/$4,600 Office Visits$20 copayDeductible + 0% Preventive Care, not Diagnostic $20 copay 100% - No Deductible Emergency Room$75Deductible + 0% Urgent Care$75Deductible + 0% All Other Covered Expenses Deductible + 15%Deductible + 0% These benefits denote in-network coverage. Please refer to the complete benefit summary for out-of-network benefits and other benefit details which differ from the amounts noted above.
17 How much do I pay when I use the insurance? Prescription BenefitsPPOHSA Out-of-Pocket Application Copays do not apply to Out-of Pocket Max Copays apply after deductible, until $1,000/$2,000 copay max, then 100% coverage Retail Tier 1$10 copay Tier 2$30 copay Tier 3$40 copay$50 copay 30 Day Supply Tier 4See Tier 325% up to $150 max Mail Tier 1$20 copay$10 copay Tier 2$50 copay$75 copay Tier 3$70 copay$150 copay 30 Day Supply Tier 4See Tier 325% up to $150 max
18 How much do I pay to have the insurance? Bi-Weekly Contributions: PPOHSA Employee Only $57.34$46.39 Employee + 1 $124.21$94.65 Employee + 2 or More $185.08$ Monthly Contributions: PPOHSA Employee Only $124.24$ Employee + 1 $269.14$ Employee + 2 or More $401.01$311.63
19 Anthem’s Online Health Tools u MyHealth Assessment u Preventive Care Guides u MyHealth Record u Condition Centers u Surgical Guides and Hospital Comparisons u Traditional and Alternative Health Library u And more
20 Flexible Spending Account vs. HSA Flexible Spending Account or Limited Purpose FSA Use-it-or-lose-it Claim must be filed Annual binding election Not portable Access to entire elected amount immediately Any IRS-approved health expense Limited Purpose FSA Health Savings Account No use-it-or-lose-it No election required Portable Use of accumulated account balance only You have total control Must be in a HDHP IRS Form 8889
21 n Review your enrollment package thoroughly. n If you are making any changes to your current Anthem medical election or dental benefits administered by MedBen, you MUST complete an enrollment form. n In order to participate in the FSA or Limited Purpose FSA benefits, you MUST complete an enrollment form. n Forms are available in the HR Office and must be completed no later than December 3, Open Enrollment Procedures