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Fuse 2015 Open Enrollment December 2014. 2 Agenda Review all 2015 insurance benefits Outline action items for enrollment / changes Q & A.

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Presentation on theme: "Fuse 2015 Open Enrollment December 2014. 2 Agenda Review all 2015 insurance benefits Outline action items for enrollment / changes Q & A."— Presentation transcript:

1 Fuse 2015 Open Enrollment December 2014

2 2 Agenda Review all 2015 insurance benefits Outline action items for enrollment / changes Q & A

3 3 Summary of 2015 Health Insurance –Staying with Cigna –Staying with HRAs –Changes to HRA funding, EE OOP Exposure & EE Contributions Dental / Vision Insurance –Changes to EE Contributions Increased limits for FSA Plan Increased benefits for STD Plan

4 4 Cigna 24/7 Customer Service Extensive Provider Network Competitive Rates Customizable Plan Designs Claims Processing

5 5 Health Insurance & HRAs Annual Deductibles – no change SingleTwo-Person / Family $5,000$10,000 HRA plan has changed to include an 80/20 co-insurance

6 6 Health Insurance & HRAs How does the 80/20 co-insurance work? 1.EE pays first $500 / $1,000 (same as 2014) 2.Fuse / HRA pays 80% of remaining claims up to deductible 3.EE pays 20% of remaining claims up to deductible Example (EE has a single plan): EE receives $2,500 hospital bill EE pays 100% of first $500 Fuse / HRA pays $1,600 (80%) and EE pays $400 (20%) of remaining $2,000

7 7 How claims are paid EE pays first $500 Fuse HRA pays 80% (up to $3,600) EE pays 20% (up to $900) Cigna pays 100% beyond $5K Single Plan $5,000 Excludes prescriptions: Rx $5 / $25 / $50 (up to $1,350) – no change $0 $500

8 8 How claims are paid EE Pays first $1K Fuse HRA pays 80% (up to $7,200) EE pays 20% (up to $1,800) Cigna pays 100% beyond $10K Two-Person / Family Plans $0 $10,000 $1K Excludes prescriptions: Rx $5 / $25 / $50 (up to $2,700) – no change

9 9 Health Insurance & HRAs With the new 80/20 co-insurance: Single $ % of all costs between $500 and $5K deductible Max Med OOP Exposure = $1,400 (+$900 from 2014) Two Person / Family $1, % of all costs between $1,000 and $10K deductible Max Med OOP Exposure = $2,800 (+$1,800 from 2014)

10 10 What Cigna Covers Preventive CarePaid at 100%, not subject to deductible Office Visits100% after $5K/$10K deductible Inpatient Hospital100% after $5K/$10K deductible Outpatient Services100% after $5K/$10K deductible ER Visits100% after $5K/$10K deductible Chiropractic Care 100% after $5K/$10K deductible Must use network provider, up to 20 visits per year Prescriptions $5 / $25 / $50, not subject to deductible Max OOP is $1,350 / $2,700 per year Mental Health100% after $5K/$10K deductible Eye ExamsNot covered Lifetime BenefitUnlimited

11 11 HRAs are administered by Cigna –NO debit cards –NO manual submissions –HRA funds cannot be used for dental, vision or prescriptions Health Reimbursement Accounts

12 12 Health Reimbursement Accounts HRA Overview HRA funds used to offset health insurance deductible “Promise to Pay” – this money is available to you only if you need it Any unused HRA funds stay with Fuse HRAs are funded solely by Fuse (no EE contributions) HRAs are not portable and revert back to Fuse upon separation of employment

13 13 Cigna Online –Register for online access at View claim history View YTD deductible info Find a doctor Order new ID cards Download claims forms

14 14 Employee Contributions Employee Monthly Payroll Contribution: SingleTwo-PersonFamily $75 $200$320 +$10/mo+$30/mo+$20/mo

15 15 Opt Out Bonus –If you opt out of Fuse’s health plan AND can provide proof of your other coverage, you will receive: Eligible for…Bonus (for 12 mo.) Single$1,000 Two-Person$1,200 Family$1,500 2P / Family but enroll as single$500 *Bonus listed is earned / paid out via payroll each pay period.

16 16 Dental & Vision Insurance Self-funded plans managed by Northeast Benefits Management (NBM) –Health plan enrollment = auto-enroll in dental & vision –If you opt out of health, you can still enroll in dental & vision –Employees submit expenses online at

17 17 Dental / Vision Reimbursements

18 18 Dental & Vision Contributions Employee Monthly Payroll Contribution: SingleTwo-PersonFamily $10/mo $20/mo$20/mo

19 19 FSA - Unreimbursed Medical Flexible Spending Accounts (FSA’s) –Managed by Northeast Benefits Management (NBM) –FSA funds can be used to pay for: OOP Medical expenses OOP Dental and Vision expenses Rx co-pays –$500 can be carried over! –Contribution limit for 2015 is $2,550 (+$50)

20 20 FSA - Dependent Care Dependent Care Account: managed by Northeast Benefits Management (NBM) –Employees can set aside up to $5,000 of pre- tax pay per year per family to be used for Dependent Care (i.e. child care) –Submit claims online at –Forfeited by end of year if not used

21 21 Other Insurance Benefits Short-Term Disability –For illness, injury or maternity –Pays 66.6% of salary (up to 13 weeks) –Maximum benefit increased to $1,500 per week Long-Term Disability –For illness or injury exceeding 90 days –Pays 60% of salary (max $6K per month)

22 Health Insurance Renewal Every eligible employee must complete the checklist and applicable forms and return to Laurie by 12/17/14 All forms and the checklist can be found on the intranet You can use Acrobat’s approval stamp; or print & sign, then

23 23 Q&A Questions?


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