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Open Enrollment – Effective January 1, 2013.  What’s new in 2013  Your benefit choices  Your employee contributions  What you need to do to enroll.

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Presentation on theme: "Open Enrollment – Effective January 1, 2013.  What’s new in 2013  Your benefit choices  Your employee contributions  What you need to do to enroll."— Presentation transcript:

1 Open Enrollment – Effective January 1, 2013

2  What’s new in 2013  Your benefit choices  Your employee contributions  What you need to do to enroll  Question & Answer

3  Disability & Life Insurance Carrier change to Anthem.  No other Carrier Changes

4  Two medical plan options through Anthem BCBS ◦ High PPO & Core HRA  Dental plan through Delta Dental ◦ Dental PPO  Vision plan through VSP  Life/AD&D and Short/Long Term Disability through Anthem

5 Plan FeatureIn-NetworkOut-of-Network Deductible (individual/family) $1,500 / $3,000 Health Reimbursement Arrangement (HRA) Account $1,100 / $2,200 Out-of-Pocket (individual/family) * $5,000 / $10,000$10,000 / $20,000 Physician Office Visits80% AD60% AD Preventative Care$0, No Deductible60% AD Inpatient Hospital80% AD60% AD Outpatient Hospital80% AD60% AD Emergency Services80% AD60% AD Pharmacy80% AD60% AD

6  Plan Highlights: ◦ Available for Core Plan enrollees only ◦ LHI will provide enrollees with partial deductible reimbursement based on their enrollment status:  Employee only coverage$1,100  Employee + Family coverage$2,200 ◦ Participants pay their portion of the deductible first, then are eligible to be reimbursed for the remainder up to the HRA credit maximum ◦ Administered by Mangrove/COBRAsource  Claim forms submitted Mangrove/COBRAsource  Obtain claim forms from benefits portal

7 Plan FeatureIn-NetworkOut-of-Network Deductible (individual/EE+1/family) None$2,000 / 4,000 / $6,000 Out-of-Pocket (individual/EE+1/family) * None$8,000 / $16,000 / $24,000 Physician Office Visits$30 PCP / $45 Specialist 30% AD (member responsibility) Preventative Care$0, No Deductible70% AD Inpatient Hospital$500/day co-pay up to $2,000 max 100% 70% AD Outpatient Hospital100%70% AD Emergency Services$150 PharmacyRetail (30 day supply) : $10 / $25 / $40 Mail Order (90 day supply) : $20 / $50 / $80

8  Tobacco-Free Program ◦ 100% coverage for telephone counseling and educational materials ◦ Also covers nicotine replacement therapy  Healthy Weight Program ◦ 100% coverage for telephone counseling with a registered dietician & health educator ◦ Includes on-line tools and educational materials  Other Programs ◦ Stress Management ◦ Physical Activity  Core Plan members can earn rewards for activities that contribute to good health & well being

9 * Fees by Premier Network dentists will be discounted & the dentist’s office will not bill patient for more that ‘approved’ fees. No Balance Billing to Patient. Or call DELTAOK Plan Feature PPO In- Network Premier Dentists* Out-of- Network Deductible (individual/family) $50 / $150 Preventative (NO deductible) 100%80% Basic Services 90%80% Major Services 60%50% Annual Dental Maximum $1,500 Orthodontia (dependent children) 50% Ortho Lifetime Maximum $1,000

10 * Note: California employees are covered under the California State Disability Income (CASDI) program; the Anthem STD benefit will integrate with CASDI for a total benefit up to, and not exceeding, 60%. Plan FeatureBenefit Short Term DisabilityWeekly Benefits = 60% of Annual Salary to a max of $2,000 per week for up to 13 weeks duration Long Term DisabilityMonthly Benefits = 60% of Annual Salary to a max of $10,000 per month

11 You may apply for these coverages by filling out the application form for them along with the simple health statement and submitting for carrier approval. As a special feature of moving to Anthem, there is a G.I. of $150,000 for this year’s open enrollment. Plan FeatureBenefit Basic Life Insurance1 x Base Annual Salary to $150,000 Basic AD&D1 x Base Annual Salary to $150,000 Optional Employee LifeIncrements between $10,000 and $500,000 (portable with $20,000+ elected) Optional Spousal LifeIncrements between $5,000 and $250,000 but may not be more than 50% of EE amount (portable with $20,000+ elected) Optional Child/ren Life$10,000

12 Plan FeatureIn-NetworkOut-of-Network Exams$10 copayUp to $45 allowance Frames$25 copay Up to $130 allowance + 20% discount over allowance Up to $47 allowance Lenses$25 copayUp to $45-$125 allowance Contact Lenses$25 copay Elective: up to $130 allowance Medically Necessary: $0 Elective: up to $105 allowance Medically Necessary: up to $210 allowance Frequency (all services) 12 months Lasik Surgery5%-15% DiscountN / A

13 * Note: These are the amounts that you pay each month for these coverages if you elect them. They are not the amounts that are taken out of each of your paychecks. Employee Tier High Plan PPO Core Plan with HRA Employee$208.15$ Employee + 1$429.29$ Employee + Family$526.88$281.52

14 * Note: These are the amounts that you pay each month for these coverages if you elect them. They are not the amounts that are taken out of each of your paychecks. Employee TierDentalVision Employee$8.45$0.00 Employee + 1$26.34$3.31 Employee + Family$47.37$7.92

15 * Note: These benefits are provided by Lawrence Holdings at no cost to you. BenefitEmployee Cost Sharing Basic Life InsuranceNone * Basic AD&DNone* Optional Employee Life100% Employee Paid Optional Spousal Life100% Employee Paid Optional Child/ren Life100% Employee Paid

16  During open enrollment: you can add or delete dependents OR enroll in a plan that you have previously waived coverage for (some waiting periods may apply).  If you have an IRS “qualifying life event” (QLE): Due to IRS regulations the elections you make for January 1 st cannot be changed unless you have a qualified status change OR life event. You can add or drop dependents to/from your plans if one of the following status changes occur during the plan year.  The addition of a dependent through marriage, birth, adoption, etc.  The loss of a dependent through divorce, death, or if a dependent looses eligibility (due to age, employment, etc.)  A change in spouses employment or benefit eligibility status  A substantial/material change in your, or your spouse’s, benefits coverage  PLEASE NOTE: changes must be made within 30 days of the qualifying event OR you must wait until the next qualifying event / plan open enrollment.

17 You will only need to complete new applications IF you are changing any of your coverage selections from your 2012 elections. All employees will need to complete and sign the LHI election/waiver form reaffirming selections for 2013, and initial benefit summary page. ActivityTiming Open Enrollment MeetingsDecember 10th – 13th Open Enrollment PeriodEnds December 21 nd Enrollment Elections Due to HRDecember 21 nd Plan Year Effective DateJanuary 1 st, 2013

18 The purpose of this presentation is to help answer questions and provide a summary of the employee benefits plans offered by Lawrence Holdings, Inc effective Please contact your HR representative with any further questions or for clarification instead of assuming anything. Though efforts have been made to ensure the accuracy of this information, it is subject to modification at any time. As always, LHI reserves the right to change or end any of its benefit plans at any time. Erin Ethier Lawrence Holdings, Inc ext 6606 Charles Andersen RSC Insurance Brokerage /


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