Presentation on theme: "Early Retiree Plan Benefit Options 2013 - 2014. Statewide, Nationwide, and Around the World Blue Plans represents the nation’s largest and most experienced."— Presentation transcript:
Early Retiree Plan Benefit Options
Statewide, Nationwide, and Around the World Blue Plans represents the nation’s largest and most experienced health care benefit companies. Blue Plans cover 100 million people— nearly one-third of all Americans—in all 50 states, the District of Columbia and Puerto Rico. Blue Cross and Blue Shield of Nebraska insures or provides benefit administration for more than 700,000 people. BLUE CROSS AND BLUE SHIELD OF NEBRASKA 2 92% Physicians 96% Hospitals Members have access to:
Introductions NSEA-Retired President - Roger Rea Union Bank - Bobbi Hanigan EHA Field Representative - Greg Long Blue Cross Blue Shield of Nebraska Kent Trelford-Thompson Sue Warner Tara Stevenson Linda Farahani Nick Stoysich 3
Agenda Plan and Rates Benefit Plan Options $750 Deductible PPO $1,650 Deductible PPO $3,100 Deductible High Deductible Health Plan $4,000 Deductible High Deductible Health Plan Health Savings Accounts How to Enroll 4
2013 – 14 Rates for Early Retirees EHA Early Retiree Rates Benefit OptionEmployeeEmployee + Children Employee + Spouse Family $750 Deductible$566.28$1,003.86$1,189.19$1, $1,650 Deductible$477.79$846.98$1,003.35$1, $3,100 Deductible$477.79$846.98$1,003.35$1, $4,000 Deductible$424.71$752.90$891.89$1,
Early Retiree Rate Comparison EHA Early Retiree Rates Benefit OptionEmployeeEmployee + Children Employee + Spouse Family $750 Deductible$566.28$1,003.86$1,189.19$1, $1,650 Deductible $3,100 Deductible $477.79$846.98$1,003.35$1, Premium Difference to $750 Plan $88.49$156.88$185.84$ $4,000 Deductible$424.71$752.90$891.89$1, Premium Difference to $750 Plan $141.57$250.96$297.30$
$750 Deductible PPO Option Deductible: $750 Employee only or $1,500 Family Coinsurance 80% - 20%: $2,250 Employee only or $4,500 Family Office Visit Copay: $30 – Primary Care Physician $50 - Specialist $50 – Ded & Coins - Urgent Care $75 – Ded & Coins - Emergency Room Routine Care Benefit: Expanded Benefits due to Affordable Care Act Pharmacy Benefit: Generic 25% Coinsurance ($5 Min - $25 Max) Formulary Brand 25% Coinsurance ($30 Min - $60 Max) Non-Formulary Brand 50% Coinsurance ($60 Min - $90 Max) 7
$1,650 Deductible PPO Option Deductible: $1,650 Employee only or $3,300 Family Coinsurance 70% - 30%: $3,250 Employee only or $6,500 Family Office Visit Copay: $45 – Primary Care Physician $65 - Specialist $65 – Ded & Coins - Urgent Care $90 – Ded & Coins - Emergency Room Routine Care Benefit: Expanded Benefits due to Affordable Care Act Pharmacy Benefit : Generic 30% Coinsurance ($7 Min - $30 Max) Formulary Brand 30% Coinsurance ($35 Min - $70 Max) Non-Formulary Brand 50% Coinsurance ($60 Min - $90 Max) 8
$3,100 Deductible: High Deductible Health Plan Deductible: $3,100 Employee or $6,200 Family Coinsurance 100% - 0%: $0 Employee only or $0 Family Office Visit Copay: Primary Care Physician – Applies to Deductible Specialist - Applies to Deductible Urgent Care – Applies to Deductible Emergency Room – Applies to Deductible Routine Care Benefit: Expanded Benefits due to Affordable Care Act Pharmacy Benefit : Generic – Applies to Deductible Formulary Brand - Applies to Deductible Non-Formulary Brand – Applies to Deductible 9
$4,000 Deductible : High Deductible Health Plan Deductible: $4,000 Employee only or $8,000 Family Coinsurance 70% - 30%: $2,350 Employee only or $4,700 Family Office Visit Copay: Primary Care Physician – Applies to Deductible & Coinsurance Specialist - Applies to Deductible & Coinsurance Urgent Care – Applies to Deductible & Coinsurance Emergency Room – Applies to Deductible & Coinsurance Routine Care Benefit: Expanded Benefits due to Affordable Care Act Pharmacy Benefit : Generic – Applies to Deductible & Coinsurance Formulary Brand - Applies to Deductible & Coinsurance Non-Formulary Brand – Applies to Deductible & Coinsurance 10
What is a Health Savings Account A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. HSA’s are owned by the individual and funds may be used to pay for qualified medical expenses. 11
Please Welcome Bobbie Hanigan Union Bank 12
Presented by: Bobbi Hanigan Union Bank & Trust Company
Benefits of an HSA You see the true cost of medical care and have better control over how your dollars are spent Funds roll over from year to year There is no “use it” or “lose it” Funds belong to you - regardless
Who Can Open a Health Savings Account? Age Requirement: 18 or older Must be enrolled in a qualifying High Deductible Health Plan (HDHP) Cannot be covered by any non-qualified HDHP Health Insurance Account is owned by the insured Unused Funds may roll over to next plan year and beyond Cannot be enrolled in Medicare Cannot be claimed as a dependent on another individual’s tax return
2013 HSA Contributions Maximum annual contribution amount for 2013 is : - $3,250 Individual coverage - $6,450 Family Coverage 2013 Catch-up Contributions for HSA owners ages $1,000 for 2009 and thereafter ****if the account owner has a spouse who is covered under the HDHP, and they are they qualify to make the catch-up contribution – this contribution would need to be into their own account!
2014 HSA Contributions Maximum annual contribution amount for 2014 is : - $3,300 Individual coverage - $6,550 Family Coverage 2014 Catch-up Contributions for HSA owners ages $1,000 for 2009 and thereafter ****if the account owner has a spouse who is covered under the HDHP, and they are they qualify to make the catch-up contribution – this contribution would need to be into their own account!
HSA Contributions (continued) Contributions can be made as late as April 15 of the following year Anyone can contribute to an HSA for you Contributions are Tax deductible (unless made by your employer) Tax-Free earnings through investments/interest Excess Contributions must be withdrawn and taxed as ordinary income plus an additional 10% excise tax
HSA Distributions Distributions for qualified medical, dental or vision expenses are not taxed Non-qualified expenses are taxable as ordinary income plus an additional 20% penalty (exceptions: individual’s death, disability or reaching age 65) Distributions for non-qualified expenses taken after age 65 are taxed current tax rate and are NOT subject to the 20% penalty
What Medical Expenses Qualify? Prescriptions and qualified deductible expenses Qualified long-term care services and a percentage of long term care insurance premiums COBRA premiums Health insurance for those on unemployment compensation Eye Exams Dental Exams
Advantages of HSAs Triple Tax Savings: Tax deductions when you contribute to your account Tax-free earnings through investments/interest Tax-free withdrawals for qualified medical expenses Portability-accounts are completely portable if you: Change your medical coverage Move to another state Change your marital status
HSA Beneficiaries Surviving spouse becomes the owner of the account and can use it as if it were their own HSA No surviving spouse? The account is no longer treated as an HSA. The account passes to your beneficiary, or becomes part of your estate (and is subject to any applicable taxes)
Two Types of Accounts to Meet Your Savings and Investment Needs Deposit HSA Variable Balance High Activity Easily Accessible Online Bill Pay FDIC Insured Account Mutual Fund Account Growth-oriented account Low level of activity Higher balances Online Management Not FDIC Insured!
Accessibility The balances in your Deposit HSA Account are immediately accessible using your: HSA Debit Card Online BillPay Checks-you may choose to purchase checks for your account! 25
Online Bill Pay 26
HSA Enrollment Process for Deposit HSA Account Union Bank & Trust is excited to announce……. E-Signature!!!! Simply log onto Select “Open Account Online” (middle of left side) Select Health Savings Account (bottom of left side) Complete application as instructed Remember to Select “EMPLOYER SPONSORED PLAN” Account is opened and you will receive your account number at this time! Remember to record it for future reference.
Health Savings Accounts Encourage Healthy Living Preventative care is not a deductible expense and is covered at 100% by your CDHP Proactive approach to health care The money that you do not use in the account is yours to keep – an incentive to live a healthy lifestyle
Account Owner Responsibility If you have specific tax questions, please consult your tax professional Union Bank & Trust is not responsible for monitoring the account for proper usage Please remember that when used properly, the Health Savings Account offers Triple Tax Savings!! Tax-Free Contributions, Tax-Free Earnings, and Tax-Free Qualified Distributions It is the Account Owner’s responsibility to maintain all records and receipts for the account
Union Bank & Trust HSA Contact Bobbi HaniganHeather Poysa (402) (402) Toll Free:
Examples of Out-of-Pocket Cost’s Hypothetical Out-of-Pocket Expense $750 PPO $1,650 PPO $3,100 HDHP $4,000 HDHP Allowable Charge is $750 Members Cost Share $750 Members Cost Share $750 Members Cost Share $750 Members Cost Share $750 Allowable Charge is $1,650 Ded = $750 20% of $900= $180 $930 Members Cost Share $1,650 Members Cost Share $1,650 Members Cost Share $1,650 Allowable Charge is $35,000 Ded = $750 Coins = $2,250 $3,000 Ded = $1,650 Coins = $3,250 $4,900 Ded = $3,100Ded = $4,000 Coins = $2,350 $6,350 31
Not Another Knee Injury Hypothetical follow-up to $35,000 Inpatient Hospital Claim Hypothetical Expense $750 Deductible$1,650 Deductible$3,100 HDHP $4,000 HDHP Inpatient Expense$3,000$4,900$3,100$6,350 Follow-up Specialist Office Visit (2) ($50 x 2) $100 ($65 x2) $130 DedDed & Coins Prescription Formulary Brand-Name ($200 x 25%) $50 ($200 x 30%) $60 DedDed & Coins Physical Therapy 6 Visits Ded & Coins DedDed & Coins Follow-Up Office Visit PCP $30$45DedDed & Coins Total Out Out-of- Pocket $3,180$5,135$3,100$6,350 32
Key Points to Remember To request an application please contact the Lincoln BCBSNE office at (402) Application Deadlines: – For January 1, 2014 effective date; all applications due to the Lincoln BCBSNE office no later than Monday December 2, Single Dental coverage is required with all plans. If you move to on of the higher deductible plans, you must stay on that option for 3 years or until you reach age 65, which ever comes first. Health Savings Accounts provide a Triple Tax Savings. If a member elects to move to the Federal Market Place, the member would not be able to return to Direct Bill Coverage. Member Service Number Once you have sent your application to BCBSNE all question should be referred to Member Services. 33