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Saint Louis University Employee Benefits 2015 Annual Enrollment.

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Presentation on theme: "Saint Louis University Employee Benefits 2015 Annual Enrollment."— Presentation transcript:

1 Saint Louis University Employee Benefits 2015 Annual Enrollment

2 Benefits Overview—Coverages Offered  Medical/Prescription Drug  Vitality Wellness Program  Voluntary Dental  Health Savings Account  Flexible Spending Accounts  Basic Term Life and AD&D  Voluntary Term Life  Voluntary AD&D  Long Term Disability  Long Term Care  Business Travel Accident New this year! (Non-Union Employees Only)  Voluntary Vision  Voluntary Accident

3 Medical/Prescription Drug Benefits Annual Enrollment 2015

4 Highlights Effective January 1, 2015  Medical - UnitedHealthcare  Plus Plan: Medical and Prescription drug copays will accumulate towards the out-of-pocket maximum in the Plus Plan  QHDHP Plan  No plan changes  Health Savings Account  The Vitality™ Wellness Program  Participants save on medical premiums and earn rewards!  Health screenings and HRA completion are needed to receive wellness discount  If covering your spouse, both must complete requirements  Deadline: November 30  Prescription Drug – Express Scripts  No plan change to prescription drug benefits  Network continues to include Walgreens and Dierbergs

5 2015 Medical Plan Options Plus PlanQHDHP Plan SLUCareIn-Network Out-of- Network SLUCareIn-Network Out-of- Network Deductible Non-Embedded: (One member can satisfy entire family deductible) Individual$0$500$750$1,500 $3,000 Family$0$1,000$1,500$3,000 $6,000 Coinsurance0%10%40%0%10%40% Out-of-Pocket Maximum (includes deductibles and all copays) Non-Embedded: (One member can satisfy entire family OOP Max) Individual$1,500 $4,750$1,500$3,000$6,000 Family$3,000 $9,500$3,000$6,000$12,000 Physician Office Visits Primary Care$10 copay 10% after ded.40% after ded.0% after ded.10% after ded.40% after ded. Specialist Care$20 copay Preventive Care100% Inpatient Hospital N/A10% after ded.40% after ded.N/A10% after ded.40% after ded. Emergency Room N/A$100 copay N/A10% after ded. Urgent Care Center N/A$50 copay N/A10% after ded.40% after ded.

6 2015 Pharmacy Plan Options Plus PlanQHDHP Plan Express Scripts Retail (34-day supply) Express Scripts Mail Order (90-day supply) Express Scripts Retail (34-day supply) Express Scripts Mail Order (90-day supply) Tier 1$8$16Medical Deductible and Coinsurance Tier 2$30$60Medical Deductible and Coinsurance Tier 3$50$100Medical Deductible and Coinsurance Tier 420% to $150N/AMedical Deductible and Coinsurance Preventive MedicationsPriced according to the tier in which they fallCovered at 100%, no copay or deductible Under the QHDHP, certain preventive, or “maintenance,” medications are covered at 100%... No deductible or coinsurance!

7 2015 Cost Sharing  No change to rates!!! Premium has remained the same for 3 years!  Wellness Incentive remains at $50 for employee only coverage and an additional $25 for spouse coverage (all or nothing discount) Plan Monthly Premium DeductionsWith Monthly Wellness Discount Plus Plan Employee Only $143.79$93.79 Employee and Spouse $386.97$ Employee and Child(ren) $332.25$ Family $520.66$ QHDHP Plan Employee Only $79.64$29.64 Employee and Spouse $252.24$ Employee and Child(ren) $210.36$ Family $328.20$ Plus Plan – Employees earning up to $33,000 Employee Only $50.00$0 Employee and Spouse $293.18$ Employee and Child(ren) $238.46$ Family $426.87$351.87

8 2015 Cost Sharing  Bi-Weekly Premiums Plan Bi-Weekly Premium DeductionsWith Bi-Monthly Wellness Discount Plus Plan Employee Only $66.36$43.28 Employee and Spouse $178.60$ Employee and Child(ren) $153.35$ Family $240.30$ QHDHP Plan Employee Only $36.76$13.68 Employee and Spouse $116.42$81.80 Employee and Child(ren) $97.09$74.01 Family $151.48$ Plus Plan – Employees earning up to $33,000 Employee Only $23.08$0 Employee and Spouse $135.31$ Employee and Child(ren) $110.06$86.98 Family $197.02$162.40

9 Health Savings Account Annual Enrollment 2015

10 Health Savings Accounts  Health Savings Accounts (HSAs) are designed to help you save and pay for your healthcare now and when you retire  Triple tax savings:  Put money in pre-tax  Grow your savings tax free  Pay for qualified medical expenses income tax free  Account is always yours

11 HSA Eligibility for Account Holders only  You are eligible to open and contribute to an HSA if you:  If you don’t meet one of these eligibility requirements, you can still enroll in the QHDHP plan, you just cannot open and contribute to a Health Savings Account Are covered by a Qualified High Deductible Health Plan (QHDHP) Are not covered by any other health plan that is not a QHDHP Are not enrolled in Medicare, Medicaid, or TRICARE Have not received VA benefits within the past 3 months Are not claimed as a dependent on someone else’s tax return Are not covered by a Health FSA (Must have $0 in your Health FSA before contributing to an HSA)

12 HSA Contributions  2015 Maximum Contribution Limit * 2014 Limits: $3,300 for Individual, $6,550 for Family  IRS maximum reflects a combined employer + employee contribution  55+ can fund an additional $1,000/year; “catch-up” contribution  Please note SLU will only put seed money into an OptumHealth administered HSA. If you choose to go to a financial institution of your choice, then you will not receive the seed money.  HSA must be established by November 30 in order to receive seed money on January 1  Funds must physically be in your account before disbursements can be made  Any money remaining in the account at the end of the calendar year rolls over into the next year 2015IRS MaximumSLU Seed Money Individual$3,350$250 Family$6,650$500

13 Taking Money OUT of an HSA  Issues in Distributions  Reimbursement of expenses for employee, spouse and Tax Code dependents are tax free  Expense must be incurred on or after the date the HSA was established  Qualified expenses include:  Health, dental and vision expenses  COBRA premiums  Medicare premiums  Qualified long-term care premiums  Retiree health insurance after age 65, but not Medigap/Supplement plans  Other withdrawals are taxable  Income tax, plus…  Subject to 20% excise tax if withdrawn prior to age 65  After you turn 65, or enroll in Medicare, you may withdraw money for non medical purposes without a penalty. The withdrawal is treated as retirement income and is subject to normal income tax.  It is important to save your receipts in case you are audited by the IRS  Account is between you and the IRS; OptumHealth bank does not substantiate your claims

14 HSA & FSA Participation  IRS guidelines prohibit participants from contributing to a Health Care FSA and an HSA at the same time  Spouses are ineligible to participate in their employer’s Health Care FSA  Ok if a Limited FSA – used for dental and vision expenses only  In order for you to fund an HSA on January 1, there must be a $0 balance in your Health Care FSA on December 31  You can still enroll in the benefit plan, but cannot contribute to an HSA account

15 Making Deposits Payroll Deduction Arrange for an automatic payroll deduction into your account Mail a Check Make a deposit at any time on OptumHealth from your checking or savings account e-Contribute Arrange a regular electronic transfer from an account at another financial institution

16 Access Your HSA Funds Use your UnitedHealthcare Health Savings Account Debit MasterCard ® Sign up for automatic bill pay and online banking Use HSA checks Pay with personal funds and reimburse yourself from your HSA

17 myuhc.com  Benefit summaries  Deductible accumulator  Treatment cost estimator  Check statements  Pay bills to health care providers  Update personal information  Learn about QHDHPs and HSAs  HSA calculators

18 Additional Programs UnitedHealthcare:  Diabetes Prevention and Control  Pre-diabetics work with YMCA lifestyle coaches to prevent the progression  Diabetics work with Shop N’ Save pharmacists face-to-face to help control and improve prescription compliance, set goals, and review lab work  Diabetes Health Plan  Members incentivized to comply with recommended Medical and Rx guidelines  Plus Plan: No office visit or pharmacy copays for diabetes-related eligible expenses  Available only when using SLUCare physicians

19 Vitality Annual Enrollment 2015

20  Earn points by:  Review and activate your personal health goals  Update or confirm your contact information  Complete an online Course to learn about a health topic  Complete a Vitality Check™ biometric screening with a Vitality partner  Schedule Healthy Habits and Preventive Screenings  Track your workouts using a Vitality-approved fitness device  Sign up at a Partner Health Club  Get CPR or first aid certified  Once you build up your points, go spend them!  Rewards in the Vitality Mall:  Amazon Gift Cards  Hotel discounts to Hyatt  iTunes gift cards  Movie theater ticket vouchers  Fitbits, Fitbugs, Garmin, and Polar devices  Charity  Please note: This list does not cover the program in its entirety. Please refer to the web site for complete program activities, rules and details.

21 Voluntary Dental Benefits Annual Enrollment 2015

22 Voluntary Dental Benefits  Coverage will remain with Delta Dental  Choose among two dental plan options  Both plans include Delta’s PPO and Premier dentists  Option 1: Flex Plan  No benefit changes  Last year the maximum was increased from $1,000 to $1,500  Option 2: Basic Plus  No benefit changes  Combination of previous Basic Plus and Basic Plan  Both in and out of network benefits

23 Voluntary Dental Plan—Delta Dental Flex OptionBasic Plus PPO NetworkOut-of-Network PPO Network OnlyOut-of-Network Deductible Individual$50 $25 Family$150$50$75 Calendar Year Maximum Per person$1,500 $1,000 Preventive Care (Member Responsibility Shown) 0% no deductible 50% no deductible Basic Restorative Care ( Member Responsibility Shown) 10% after deductible30% after deductible 65% after deductible Major Restorative Services (Member Responsibility Shown) 40% after deductible60% after deductible 80% after deductible Orthodontia Lifetime maximum (per person)$1,000 Orthodontia 50% For adults and children to age 26 60% For adults and children to age 26 50% For children to age 19 only 75% For children to age 19 only

24 2015 Dental Contributions FlexBasic Plus Monthly Single$36.01$21.07 Two-person$70.49$40.52 Family$120.69$72.60 Bi-Weekly Single$16.62$9.72 Two-person$32.53$18.70 Family$55.70$33.51

25 Voluntary Vision Benefits Annual Enrollment 2015

26 Voluntary Vision Benefits  New benefit this year! (Non-Union employees only)  Offered through Vision Service Plan (VSP)  Plan includes benefits for eye exam, frames, contacts, etc.  In-Network vs. Out-of-Network  In-Network = no claim forms to complete  Out-of-Network = must submit claim form for reimbursement  VSP.com  Find a provider  Network: Choice  Register and review benefit information  Discounts available  Print an ID card (not necessary to use benefits)  Plan is 100% employee paid

27 Voluntary Vision Plan—VSP Vision Plan In-NetworkOut-of-Network Exam Wellvision Exam$10 copayUp to $45 allowance Lenses Single$10 copayUp to $30 allowance Bifocal$10 copayUp to $50 allowance Trifocal$10 copayUp to $65 allowance Frames $150 allowance for a wide selection of frames; $170 allowance for featured frame brands; 20% on the amount over your balance Up to $70 allowance Contacts (in lieu of glasses) $150 allowance for contacts; including the contact lens exam (fitting and evaluation) Up to $105 allowance Frequency Exam/Lenses/Contacts (in lieu of glasses)Every calendar year FramesEvery other calendar year

28 2015 Vision Contributions Vision Plan Monthly Employee Only $7.02 Employee and Spouse $12.76 Employee and Child(ren) $13.38 Family $20.33 Bi-Weekly Employee Only $3.24 Employee and Spouse $5.89 Employee and Child(ren) $6.18 Family $9.54

29 Voluntary Accident Benefits Annual Enrollment 2015

30 Voluntary Accident Benefits  New benefit this year! (Non-Union employees only)  Offered through Voya Financial (formerly ING)  Plan reimburses expenses that occur due to an accident  Coverage is guarantee issue – no health questions asked  No “Network”  When you have an expense, you must submit a claim form; reimbursement will then be mailed as a check  24-hour coverage – accidents on or off the job are eligible  Plan is 100% employee paid

31 Voluntary Accident Plan—Voya Service Benefit Amount Accident Hospital Care Surgery (open abdominal, thoracic)$1,200 Hospital Confinement$250/day up to 365 days Coma (14 or more days)$6,000 Follow-Up Care Medical Equipment$120 Physical Therapy$30/treatment (6 max) Prosthetic Device$6,000 Emergency Care Ground Ambulance Transport$120 Air Ambulance Transport$600 Emergency Room Treatment$180 Common Injuries Burns, Laceration, Torn Knee Cartilage, Paralysis, Tendon/Ligament/Rotator Cuff Varies Service Benefit Amount Common Injuries – Dislocations Hip Joint$2,400/$4,800 Knee$1,200/$2,400 Shoulder$360/$720 Common Injuries – Fractures Hip$1,800/$3,600 Leg$960/$1,920 Ankle$360/$720 Kneecap$360/$720 Nose$120/$240 Other Benefits Wellness Benefit (completion of health screening test) $100/employee or spouse $50/child (max of 4) Sickness Hospital Confinement Benefit $100/day for employee or spouse $75/day for children Below is a sample list of benefits, it does not include all the benefits available under the policy.

32 2015 Accident Contributions Accident Plan Monthly Employee Only $24.74 Employee and Spouse $41.90 Employee and Child(ren) $39.62 Family $56.78 Bi-Weekly Employee Only $11.42 Employee and Spouse $19.34 Employee and Child(ren) $18.29 Family $26.21

33 Flexible Spending Accounts Annual Enrollment 2015

34 Flexible Spending and Dependent Care Accounts  Administration will remain with ConnectYourCare  You must make a new election for the 2015 plan year; current elections cannot be carried forward  Debit card allows direct payment  Eases payment, but does not substantiate claims – receipts may still be needed!  Use at authorized vendors (medical facilities, hospitals, pharmacies, etc.)  Remember if you are electing the QHDHP plan and open an HSA, the IRS requires your Health FSA balance to be $0.00 on January 1, 2015 before contributing to an HSA

35 Flexible Spending and Dependent Care Accounts  Due to health reform, annual maximum for the Health FSA will be remain at $2,500  Annual maximum for the Dependent Care Account will remain at $5,000 ($2,500 if married and filing separate returns)  For the Health FSA  Total election amount less previous reimbursements is available at the time of transaction  For the Dependent Care FSA  Only the cash balance in your account is available at the time of transaction  You cannot roll over unused balances from one year to the next  Use it or lose it rule applies

36 Eligible Medical FSA Expenses  Copays, coinsurance and deductibles for medical, prescription and dental plans  Eye exams, contacts and eyeglasses  Laser eye surgeries  Hearing aids  Over-the-counter medical supplies  Bandages, splints, contact lens solution, etc.  Over-the-counter medical medications must be accompanied by a prescription  Insulin  Some expenses not covered by your medical plan

37 Annual Enrollment 2015

38 2015 Annual Enrollment  Plan elections are binding for the 2015 plan year, unless you experience a qualifying life event:  Marriage  Birth/adoption  Divorce  Death  Change in employment status  Change in dependent status  Life status changes allow you to make benefit election changes  The Benefits Department must be notified within 31 days of life change

39 2015 Annual Enrollment  Enrollment season is November 1 through 30  If making changes, do so through Banner Self-Service  Current medical and dental elections will carry forward  Must actively enroll in vision and accident plans, if interested  New and existing HSA, Dependent Care and Health FSA participants will need to make an election for Current deductions will not carry forward.  New HSA participants will also need to establish an OptumHealth bank account by November 30 in order to receive seed money  Update beneficiary information if necessary  All enrollment elections must be completed online no later than Sunday, November 30, 2014  Benefits Office will be closed Thursday, November 27 and Friday, November 28  Contact or with

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