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2015 Employee Benefits November 17 & 18, 2014. Open Enrollment  Elections made during open enrollment will become effective on January 1, 2015.  East.

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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:

1 2015 Employee Benefits November 17 & 18, 2014

2 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,

3 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

4 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

5 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

6 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

7 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.

8 IRS HSA Contribution Limits 2015 Contribution Limit Individual Coverage$3,350 Family Coverage $6,650 Catch up (Age55 to 65) $1,000 8

9 Medical Plan and Network Options PlansNetworks Base Blue Access Choice (BAC) BJC Network Blue Preferred Select (BPS) Non-BJC Network HSA 9

10 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

11 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

12 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%.

13 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.

14 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.

15 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

16 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

17 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

18 Questions 18 Nancy & Jodie


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