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Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA.

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Presentation on theme: "Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA."— Presentation transcript:

1 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA COLBY COLLEGE your medical plan options Plan year: 1/1/ /31/2010 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA

2 2 Today’s Discussion: *2010 Benefit Plan Options *Consumer-Driven Health Care Overview *Health and Wellness Resources and Tools *Customer Service Support *Ways to Learn More *Questions and Answers The Plan is easy to work with. The Plan protects you from the unexpected. We help you be well and live well. Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA

3 Medical Plan Options - Open Access In-Network - Open Access Plus - Choice Fund – Health Savings Account Key Features/Advantages No Primary Care Physician required ( optional ) No Referrals required for specialist ( in-network providers ) Access to National Network/CareLink Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA

4 Plan Differences BenefitCurrent HMOOpen Access In-Network Specialist$20 copay$25 copay Advanced Radiology (MRI, CAT, PET Scans) 100%$50 copay per scan/per day Short-Term Rehab (PT/OT/ST)$20 copay$25 copay Chiropractic Care$20 copay, 36 visits$25 copay, unlimited Prescriptions Preferred Brand Name Non-Preferred Brand Name $25 copay $40 copay $30 copay $50 copay Emergency Care$25 copay$100 copay

5 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA Plan Differences BenefitCurrent CompCareOpen Access Plus In-NetworkOut-of-NetworkIn-NetworkOut-of-Network Deductible$250 Individual/$500 Family$500 Individual/$1,000 Family Out-of-Pocket Maximum $1,250 Individual/$2,500 Family$1,500 Individual/$3,000 Family Preventive Care Office Visit Regular Physician Office Visit $10 copay Deductible/ Coinsurance Deductible/ Coinsurance Deductible/ Coinsurance $20 copay Deductible/ Coinsurance Deductible/ Coinsurance Specialist Office Visit Deductible/ Coinsurance Deductible/ Coinsurance $20 copayDeductible/ Coinsurance Short-Term Rehab (PT/OT/ST) Deductible/ Coinsurance Deductible/ Coinsurance $20 copayDeductible/ Coinsurance Chiropractic CareDeductible/ Coinsurance Deductible /Coinsurance $20 copayDeductible/ Coinsurance

6 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 6 Medical Plan Highlights I want a plan that provides protection from the unexpected. How do you protect me financially? Open Access Plus In-Network (formerly HMO) Open Access Plus (formerly CompCare) In-Network Out-of-Network Coinsurance after Deductible 100%None80% after deductible60% after deductible Deductible – what you pay before the plan pays Cross Accumulation None $500 Individual $1000 Family $500 Individual $1000 Family Out-of-pocket maximum Cross Accumulation None $1500 In-network $3000 Out-of-network $1500 In-network $3000 Out-of-network Lifetime maximumUnlimited Preventive Care Office Visit Copayment Routine Care Office Visit Copayment $20 Primary Care Physician $20 Primary Care Physician/$25 Specialist Copay $20 Primary Care Physician $20 Specialist 60% after deductible Inpatient Hospital/Outpatient Facility Services 100%80% after deductible60% after deductible Emergency Room/ Urgent Care $100 copay $50 copay 80% after deductible 80% after deductible if a true emergency; otherwise 60% after deductible Lab and Radiology Services100%80% after deductible60% after deductible

7 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 7 Prescription Plan Highlights I want a plan that provides protection from the unexpected. How do you protect me financially? Open Access In-NetworkOpen Access Plus Retail 30-day supply ME Retail/ Mail Order 90-day supply Retail 30-day supply ME Retail/ Mail Order 90-day supply Generic$10$20$10$20 Preferred Brand$30$60$25$50 Non-Preferred Brand$50$100$40$80

8 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 8 Medical Plan Highlights I want a plan that provides protection from the unexpected. How do you protect me financially? Choice Fund – Health Savings Account (Open Access Plus underlying medical plan) SingleFamily Combined Medical & Pharmacy Deductible – what you pay before the plan pays* Cross Accumulation $1500 In-network/ $3000 Out-of-network $3000 In-network/ $6000 Out-of-network Coinsurance after Deductible 80% In Network/ 60% Out-of-Network 80% In Network/ 60% Out-of-Network Office Visit CopaymentN/A Out-of-pocket maximum** Cross Accumulation $3000 In-network $6000 Out-of-network $6000 In-network $12000 Out-of-network HSA contribution from employer$750 ($62.50 per month)$1500 ($ per month) Lifetime maximumUnlimited *Deductible- If enrolled in a family plan, all family members contribute to the family deductible which must be satisfied before the plan coinsurance is applied to any family member’s claims. ** Out-of-Pocket Maximum- If enrolled in a family plan, all family members contribute to the family out-of-pocket maximum which must be satisfied before any family member’s claims are covered at 100%.

9 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 9 Prescription Plan Highlights I want a plan that provides protection from the unexpected. How do you protect me financially? CIGNA Choice Fund ® with Health Savings Account*** Retail 30-day supply Retail/Mail Order 90-day supply 10% coinsurance, after plan deductible 20% coinsurance, after plan deductible 30% coinsurance, after plan deductible ***Preventive Drugs covered at 100%, no plan deductible Medical Conditions include Hypertension, High Cholesterol, Diabetes, Asthma, Osteoporosis, Stroke, Prenatal Nutrient Deficiency.

10 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 10 No copayment due at time of visit 100% preventive care covered (includes periodic well visits, routine immunization and screenings)* Account can be used to pay the deductible Cap on out-of-pocket expenses for in-network care Unused dollars rollover to next year * Refer to Preventive Care Flyer for recommended Well-Child Care and Adult Care I’ve heard these Health Savings Account plans are unique. How is this different from a traditional plan?

11 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 11 A tax advantaged health plan that provides coverage for current medical/pharmacy expenses and allows the option to save for future health expenses. Combines a Qualified Medical Plan (medical/pharmacy coverage) with a Health Savings Account. You, your employer or both can contribute to the Health Savings Account. Money deposited into the Health Savings Account is generally not taxable. You have the option to invest the money into interest-bearing investment vehicles. Interest on these investments is also not taxable. What Is a Health Savings Account (HSA) plan? + = Qualified Medical Plan Tax Advantaged HSA Plan

12 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 12 *In/Out-of-Network Coverage Level How does an HSA work? IndividualFamily Out-of-Pocket Max 100% after $3000/$6000* Deductible $1,500/$3000* Health Coverage 80%/60%* Preventive Care 100% Deductible Out-of-Pocket Max 100% after $6000/12000* Deductible $3,000/$6,000* Health Coverage 80%/60%* Preventive Care 100% Deductible Contributions can be used to pay for current year qualified health expenses or saved to pay for future health expenses Contribution $750 Employer + Employee $ Contribution $1500 Employer + Employee $

13 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 13 Because HSA Plans have special tax advantages, the IRS defines specific rules on participation. To be eligible you: Must be enrolled in a qualified HSA medical plan (CIGNA Choice Fund is a qualified medical plan) Cannot have any other health coverage Not covered by spouse’s medical or pharmacy plan Not covered through Medicare Part A or Part B Not covered through a general-purpose Flexible Spending Account (FSA) plan (either Employer’s or Spouse’s) Cannot be claimed as a dependent on another person’s tax return Am I eligible to participate in a HSA plan?

14 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 14 What is the maximum I can contribute annually to the HSA? Because HSAs offer special tax advantages, the IRS puts limits on the maximum amount that can be contributed to the account: Under age 55 and not enrolled in Medicare: (based on a 12 month period) up to $3,050 individual coverage* up to $6,150 family coverage* Age 55 or older: Maximum contribution increases by $1,000 (considered a “catch-up” contribution) up to $4,050 individual coverage* up to $7,150 family coverage* To make the maximum contribution in a calendar year, you must: Meet all requirements to be eligible for HSA contributions on January 1 Remain qualified through December 1 If these criteria are not met, maximum contribution is prorated = 1/12 maximum contribution for each month individual is qualified *Employer contributions reduce the maximum an employee can contribute by an amount equal to the contribution.

15 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 15 Karen Single, in her 50s Heart disease; controlling health through medication Looking to save money for future health expenses HSA Deposits by Karen $1500 by Employer $750 Preventive Care $ 398 ER Visit $2,600 4 PCP Visits $ 320 Generic Rx (12) $ 288 Brand Rx (3) $ 240 Medical Expenses $3,448 How Expenses Are Paid Preventive $ 398 (100% by Plan) Applied to deductible $1,500 $1948 Paid by Plan (80%) $1, Paid by Karen (20%) $ *In/Out-of-Network Coverage Level Out-of-Pocket Max 100% after $1,500/$3,000* Deductible $1,500/3,000* Health Coverage 80%/60%* Preventive Care 100% Deductible Contribution $750 Employer + Employee $1500 Total HSA Contribution $2, What Karen Paid from HSA $1, Remaining HSA Balance $ Paid from Karen’s Fund Deductible $1, % Coinsurance $ Karen’s Premium Contribution ($26 x 12) $ Total Annual OOP $2,201.60* *Colby Contributed $750 towards Deductible

16 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 16 Karen’s Claim Example on Open Access In-Network Plan Preventive Care $ 398 ER Visit $2,600 4 PCP Visits $ 320 Generic Rx (12) $ 288 Brand Rx (3) $ 240 Medical Expenses $3,846 How Expenses Are Paid Paid by Plan (100% minus copays ) $3,558 Paid by Karen (copays) $ 310 Karen’s Premium Contribution ($46x12) $ 552 Total Annual Out of Pocket $ 862 What Karen Paid $20 copay $100 copay $ 80 in copays $120 in copays $ 90 in copays $ 310 Total Paid Out of Pocket

17 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 17 Karen’s Claim Example on Open Access Plan Preventive Care $ 398 ER Visit $2,600 4 PCP Visits $ 320 Generic Rx (12) $ 288 Brand Rx (3) $ 240 Medical Expenses $3,846 How Expenses Are Paid Paid by Plan $2,631 (coinsurance, balance on office visits and prescriptions) Paid by Karen $1,215 (ded.,/coinsurance and copays) Karen’s Premium contribution ($55x12) $ 660 Total Annual Out of Pocket $1,875 What Karen Paid $20 copay $500 Deductible plus $420 coinsurance $ 80 in copays $120 in copays $ 75 in copays $1,215 Total Paid Out of Pocket

18 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA Before opening the account, JPMorgan Chase will: Verify your identity (required by the Federal government) using information provided in the HSA application and enrollment Notify you if additional documentation to verify name, social security number or address is needed JPMorgan Chase will send your HSA information and a debit card within 7-10 days of the start of the plan year or the verification of identity (whichever is later) ID Cards are mailed from CIGNA, Debit cards are mailed separately from JPMC I need help enrolling. How do I open an HSA Bank Account?

19 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 19 What Are My HSA Investment Options? $2,000 minimum in HSA to invest Once the investment account is open, no minimum balance applies Eight mutual funds from which to choose Investments can be allocated into one fund or multiple funds No minimum deposit for any fund Tax-free growth of interest or investment earnings Monthly fees apply Online trading – no fees apply Track your balance online or with convenient monthly statements

20 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 20 Customer Service to Help Manage the HSA HSA Customer Service: By Phone One toll-free number – on the back of the ID card and Debit Card Available 24 hours a day, 7 days a week Specially-trained Customer Service Representatives answer questions about: Medical and pharmacy benefits and claims HSA IRS requirements HSA transaction activity and balance Warm transfer to JPMorgan Chase for specialized activity (investments, lost debit card, debit card transaction questions) Direct individuals to tools available via myCIGNA.commyCIGNA.com Online Single sign on to Medical and HSA activity through myCIGNA.com Medical/pharmacy information Find a physician or facility participating in the CIGNA network Access cost and quality tools Home Delivery Pharmacy Program HSA bank account information Manage investment accounts via link to JPMorgan Chase

21 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 21 24/7 Online Health Account Management Personalized and secure online account tool Review plan coverage levels Check available balances Track claims and payments Get HSA bank account information Manage investment accounts via link to JPMorgan Chase My life is busy. How do you help me understand and track my health care expenses? Hello Karen 1515 Tools to find and compare cost and quality care Manage Bank Account Manage Medical Plan Logged in as: Karen Smith At-A-Glance Account Summary Karen Smith

22 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 22 My life is busy. How do you help me understand and track my health care expenses? Explanation of Benefits Mailed to your home after each claim Shows how and when claims were paid, and how it impacted your HSA Health Statement Mailed to your home quarterly Shows year-to-date deductibles, out-of-pocket expenses, and all claim activity for that quarter

23 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 23 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA Helping you be well and live well.

24 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 24 Getting Started – Meet Your CIGNA Health Advisor ® Health Advocates Can Help You: Reduce risks identified in your health assessment Set and work toward health improvement goals Keep you motivated Your CIGNA Medical Plan Options include free access to CIGNA Health Advisor – your personal health advocate. Our team of health advocates includes nurses, nutritionists, exercise physiologists, health educators and more. CIGNA will match you with a health advocate whose expertise best matches your health needs. You’ll work with the same health advocate each time you call. Call the number on your CIGNA ID Card to get started. Refer you to additional health support resources as necessary Evaluate treatment options Answer questions about your health and your benefit plan Get the most from your medical plan Available by Phone Weekdays and Weekends Days and Evenings

25 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 25 Additional CIGNA Health Support Programs 24-Hour Health Information Line SM – Speak to a nurse anytime day or night, weekdays or weekends for urgent or routine health questions. Healthy Rewards ® * – Get valuable discounts on laser vision correction, smoking cessation supplies, Weight Watchers, drugstore.com and more. Well-Being newsletter – Online newsletter on myCIGNA.com provides helpful tips on ways to stay healthy and reduce health risks. Well Informed – Notification of potential gaps in care, such as missed screenings or missed prescription refill. Well Aware for Better Health – Coaching support to help individuals manage chronic health conditions. Lifestyle Improvement Programs – Coaching support to help individuals lose weight, stop smoking or reduce stress. Employee Assistance Program – Support to help individuals balance work/life issues. * Some Healthy Rewards programs are not available in all states. If your CIGNA plan includes coverage for any of these services, this program is in addition to, not instead of, your plan benefits. A discount program is NOT insurance, and you must pay the entire discounted charge.

26 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 26 Compare Hospital Cost and Quality Find CIGNA Centers of Excellence Features Quickly compare cost and quality using 1-3 star rating system Ratings for 19 conditions Ratings based on Healthshare plus CIGNA data 1 – 3 star rating system 3 Stars = Center of Excellence

27 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 27 Compare Pharmacy Pricing on myCIGNA.com Pharmacy Plan – Prescription Drug Price Quotes Features Learn actual prices you’ll pay Compare cost between retail pharmacies and CIGNA Tel-Drug home delivery See cost for generic equivalent, if available

28 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 28 Life is unpredictable. How can I reach you when I need help? Call us anytime day or night – live, 24/7 customer service Find information when you need it at myCIGNA.com For J.D. Power and Associates Certified Call Center Program SM information, visit Fund OA Plus HSA

29 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 29 Need Help Understanding Your Medical Plan Options? Contact the Pre-Enrollment Information Line hours a day, 7 days a week For assistance during Open Enrollment and after you are enrolled

30 Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA 30 THANK YOU for your time! Questions? The Plan is easy to work with. It protects you from the unexpected. We help you be well and live well. Confidential, unpublished property of CIGNA. Do not duplicate or distribute. Use and distribution limited solely to authorized personnel. © 2009 CIGNA


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