Presentation on theme: "2015 Employee Benefits November 17 & 18, 2014. Open Enrollment Elections made during open enrollment will become effective on January 1, 2015. East."— Presentation transcript:
2015 Employee Benefits November 17 & 18, 2014
Open Enrollment Elections made during open enrollment will become effective on January 1, East Central College offers you and your eligible family members a comprehensive and valuable benefits program. We encourage you to take the time to educate yourself about your options and choose the best coverage for you and your family. All enrollment forms must be submitted to the Human Resource Office by December 5,
Who is Eligible? Full-time employees who work a minimum 30 hours per week are eligible for Medical, Dental, Vision, Voluntary Life, and Disability. Spouses, Same-Sex Spouses of employees who were married in a jurisdiction that recognizes same-sex marriage and Dependent Children of eligible full-time employees may enroll in Medical, Dental, Vision and Voluntary Life. 3
How to Make Changes Unless you have a qualified event, you cannot make changes to the benefits you elect until the next open enrollment period. Qualified events include: Marriage Divorce Legal separation Birth or adoption of a child Change in child’s dependent status Death of spouse, child, or other qualifying dependent Change in spouse’s benefits or employment status 4
Dental, Life, AD&D 5 Coverage Type Employee Monthly Cost Dental2015 Employee Only$0.00 Employee & Spouse$30.80 Employee & Child(ren)$67.72 Family$ Guardian Dental, Life Insurance, AD&D No Plan Changes No Rate Changes
Vision 6 Coverage Type Employee Monthly Cost VSP2015 Employee Only$0.00 Employee & Spouse$3.64 Employee & Child(ren)$3.84 Family$9.88 Vision Service Plan (VSP) renewal change plan design - 3% 4-year rate lock Increase material copayment from $25 to $30
Flexible Spending Account (FSA) Plan Annual Maximum Contribution Medical $2,550* Dependent$5,000 7 * Annual Maximum Increased $50 Return completed election forms to Human Resources by December 5, 2014.
IRS HSA Contribution Limits 2015 Contribution Limit Individual Coverage$3,350 Family Coverage $6,650 Catch up (Age55 to 65) $1,000 8
Medical Plan and Network Options PlansNetworks Base Blue Access Choice (BAC) BJC Network Blue Preferred Select (BPS) Non-BJC Network HSA 9
BJC Providers 10 BJC Network (Blue Access Choice – BAC) Barnes-Jewish Hospital Barnes-Jewish St. Peters Hospital Barnes-Jewish West Hospital Boone Hospital Center Christian Hospital Missouri Baptist Medical Center Missouri Baptist Sullivan Hospital * Northwest Healthcare Progress West Hospital St. Louis Children’s Hospital The Rehabilitation Institute of St. Louis Washington University Physicians * Missouri Baptist Sullivan Hospital is also in the Non-BJC Network
Non-BJC Providers 11 Non BJC Network (Blue Preferred Select - BPS) Mercy Hospital - Washington Mercy Hospital – St. Louis Missouri Baptist Sullivan Hospital St. Louis University Hospital (SLU) St. Luke’s Hospital St. Joseph Health Center St. Joseph Hospital West Cardinal Glennon Hospital SSM St. Clare Health Center This is not a comprehensive list. Access for a complete provider directory.www.Anthem.com
Prescription Drug Plans 12 Prescription Drug Base PlanHSA Plan* Retail: Tier 1 $15Deductible then $15 Tier 2 $40Deductible then $40 Tier 3 $75Deductible then $75 Mail Order: Tier 1 $30Deductible then $30 Tier 2 $80Deductible then $80 Tier 3 $150Deductible then $150 * Once the$5,000 ($2,600 + $2,400 HRA) individual deductible is met, copayments will apply for up to $1,450, then Rx benefits are paid at 100%.
Medical Plan Calendar Year In-Network Deductible 13 Base PlanEmployeeHRA Individual$2,500$1,000$1,500 Family$5,000$2,000$3,000 HSA PlanEmployeeHRA Individual$5,000$2,600$2,400 Family$10,000$5,200$4,800 Employees’ are responsible for their share of the deductible first, then the HRA will fund the remaining deductible.
What is an Health Reimbursement Arrangement? (HRA) A fund that is used towards your In-Network Deductible. Is used for “qualified” out-of-pocket medical expenses for yourself, spouse and dependent(s). Helps reduce your out-of-pocket maximum expenses. Is excluded from your gross income; in other words, the reimbursements are tax-free.
What Is An Explanation of Benefits (EOB)? An Explanation of Benefits (EOB) explains how your medical claims are processed. You will receive an EOB from Anthem or you may access a copy online. An EOB is not a billing statement. 15
The Claim Process Go to an In-Network Provider for medical services Provider submits the claim to Anthem Anthem processes the claim Anthem then sends to Rite Choice for HRA Processing Anthem creates an EOB* and sends to member * EOB – Explanation of Benefits If the up-front deductible has not been met. Member responsible for amount due Rite Choice applies charges to the deductible If the up-front deductible has been met. Rite Choice reimburses the Provider Rite Choice creates an EOB* and sends to member Review EOB*; compare with bill to see member responsibility 16
HRA Time Table Medical Claim Receive your Explanation of Benefits (EOB) from Anthem. 5-7 Working days later you should receive the EOB from Right Choice showing what the HRA paid. Prescriptions Pay for the prescription at the pharmacy. You will receive your EOB from Anthem. 2-3 weeks later you should receive the EOB from Right Choice showing what the HRA paid. HRA Summary You will receive an EOB summary from Right Choice once a month showing any activity for all family members covered. If you had no reimbursement from the HRA you will not receive the HRA EOB. 17