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Your 2012 Benefits Employee Meeting Partnering for a Healthier Community November 2011.

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Presentation on theme: "Your 2012 Benefits Employee Meeting Partnering for a Healthier Community November 2011."— Presentation transcript:

1 Your 2012 Benefits Employee Meeting Partnering for a Healthier Community November 2011

2 Content: Enrollment What’s new for 2012 Introducing Health Advocate Choosing the right medical plan Incentives Flexible spending accounts Dental and vision Answer your questions 2 Open Enrollment November 1 – November 30

3 What you can do during Open Enrollment Elect or change medical plan options –The HRA Plan or the Choice Plus PPO Plan –Dental and vision benefits are included Set aside money in a flexible spending account –Health care or –Dependent care or –Both Add life insurance or increase coverage for you and your family 3 Other benefits :: Employee Assistance Program No enrollment Long-term disability insurance University paid No enrollment Tax-Deferred Retirement Savings Plan Join Increase contributions Invest

4 Do you have to enroll? Yes, if you want to: –Change your current medical plan –Add more life insurance –Add dependents –Add or continue a flexible spending account – your election does not carry over to next year No, if you want to continue your current elections and do not want to participate in a flexible spending account 4

5 What’s new in benefits beginning January 1, 2012 Introducing Health Advocate New contribution rates Changes to the pricing tiers in the prescription drug plan 5

6 Health Advocate Enroll in a medical plan and a Personal Health Advocate will be a resource for: –Learning more about your health condition or diagnosis –Identifying the right doctors and specialists –Resolving medical billing and claim issues –Assisting with elder care and Medicare issues You, your spouse and children, your parents and the parents of your spouse are all covered No cost to you Who is Health Advocate? National advocacy and assistance company Mission: to help individuals get the very best health care services A health care professional is a phone call away 866-695-8622 6

7 What else is new beginning January 1, 2012 New payroll contribution rates for the medical plans - See the rate sheet with your enrollment materials - Remember, you can lower your rates by completing your Personal Wellness Profile Changes to prescription drugs - Some prescription drugs will change tiers or clinical programs - Lipitor will have a generic-equivalent that will cost more than the Lipitor brand name, meaning the brand name will be in a lower-cost tier - Go to or call the phone number on your ID card for more information 7

8 Which medical plan is right for you? Two choices in medical plans: 1.The HRA Plan 2.The Choice Plus PPO Plan 8

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10 TIP: Use your FSA to help you pay out-of-pocket expenses after your HRA is spent 143 Present ID card to doctor 1 Doctor sends claim to UnitedHealthcare UnitedHealthcare applies network discount 2 UnitedHealthcare pays provider from HRA If HRA is spent 1. Provider bills you for payment 2. After deductible, provider bills you for your share of coinsurance 3 When you have claim activity, you will receive a Statement. 4 The HRA Plan Payment process 10

11 Learn more at Health Care Lane Want more help to understand the The HRA Plan? Talk with Paul, the mechanic, and he will give you the nuts and bolts on how this plan works Click on “Campbell’s Auto Care.” 11

12 The Choice Plus Plan When you use in- network providers SingleFamily You pay out of pocket up to the annual deductible amount $1,000$2,000 You and plan share coinsurance Plan pays 80% Except for copays, the plan pays 100% after your share reaches the out-of-pocket maximum $2,000$4,000 For example, the plan pays 100% of the cost of a visit to your doctor’s office after you pay a $20 copay. You pay the copayment each time, even after the out-of-pocket maximum is reached. 12 Out –of-network providers have a separate annual deductible and out-of- pocket maximum. For maximum value, use in-network providers. See the Benefits Decision Guide for details.

13 Both plans cover Preventive Care at 100% 13

14 Preventive vs. non-preventive Preventive care: Routine annual screenings to “prevent” illness or injury Non-preventive care: If diagnosed with a condition, some screenings often considered part of treatment. Be sure to talk to your doctor. 14 More information on preventive care coverage can be found at

15 Retail (30-day supply) Mail order (90-day supply) Tier 1Greater of 10% or $6 Tier 2Greater of 20% or $20Greater of 20% or $40 Tier 3Greater of 30% or $30Greater of 30% or $60 Pharmacy – Choice Plus PPO Plan 15

16 Pharmacy - The HRA Plan 16 Your HRA and you pay actual cost of medications until the HRA Plan’s annual deductible is met Then, you pay 20% coinsurance for covered medications (pay coinsurance at the pharmacy)  Up to the HRA Plan’s annual out-of-pocket maximum; then the HRA Plan pays 100% 

17 The pharmacy payment process – The HRA Plan 143 Present ID card to pharmacy. 1 Pharmacy verifies eligibility and any amount you owe at the point of sale. 2 You pay pharmacy any copayments or amounts not covered by available coinsurance 3 When you have claim activity, you will receive a Health Statement. 4 17

18 How can you reduce your medical plan’s payroll contributions? Complete a Personal Wellness Profile questionnaire Between November 10 and December 8, 2011 And reduce your rates for 2012 Must complete every year to continue the reduction Your health information is confidential and protected by the HIPAA Privacy Rule. The University does not have access to individual health date or Personal Wellness Profiles. 18

19 How to earn your discount 1.Schedule your appointment 2.Show up for your 20-minute screening 3.Receive your Personal Wellness Profile 4.Go online to complete the questionnaire 5.Visit your doctor to discuss the results – this consultation is covered as preventive care See the rate sheet for rate comparison 19

20 Incentives for HRA Plan participants Complete these Health Steps Rewards are added to your Health Reimbursement Account Which Healthy steps are you ready to take?Reward 1 Complete onsite bio-metric screening and online health questionnaire $100 per family, per year 2 Complete the Tobacco Cessation Program$100 3 Complete the Weight Loss Management Program$100 4 Participate in the Personal Health Coaching Program or Disease Management Program $300* *$100 when you enroll into the program, $200 when you complete it. 20

21 What is a Flexible Spending Account? Flexible spending accounts, or FSAs, help you pay for out-of-pocket health care or dependent care expenses. 21

22 How FSAs work You sign up each year to have a certain amount deducted pre-tax from each paycheck When you have out-of-pocket eligible expenses, you can use your FSA to reimburse yourself for those costs Eligible expenses are defined by the IRS 22

23 How FSAs work Plan carefully, start small until you gain experience − FSA funds must be spent within the plan year or balance is forfeited − Funds do not roll over year to year But, you have a “grace period” of up to 2½ months following end of plan year − Spend by March 15 of the following year − File by March 31 of the following year 23

24 Health care FSA You can set aside $8,000 for 2012 Use it for (but not limited to): –Copayments and deductibles –Dental and vision expenses –Hearing aids –Prescription drugs –Certain over-the-counter medications, if prescribed by a doctor 24

25 Dependent care FSA You can set aside up to $5,000 for 2012 Use it for: –Qualified day care expenses for children under 13 –Adult dependents not capable of caring for themselves –Babysitters, day care and day camps may qualify 25

26 Managing your FSA is easy with View your medical and FSA claims online Use direct deposit Money deposited right into your personal checking or savings account Saves paper … go green! Turn on auto-rollover Pay out-of-pocket and money automatically transfers to your FSA If you enroll in the HRA Plan, eligible expenses are automatically paid from your HRA first, then your FSA 26

27 Other resources at Find network doctors/hospitals Estimate costs Track claims status Build a health improvement program Keep a Personal Health Record Get health product discounts Review plan details 27

28 Dental benefits Included with medical plan Preventive care: Plan pays 100% (no deductible) Deductible: $50 deductible for single or $150 for family The plan covers –Basic services at 80%, such as oral surgery and root canal therapy, after the deductible –Major services at 50%, such as crowns, dentures and bridges, after the deductible Annual maximum benefit is $1,000

29 Vision care benefits Included with medical plan In-network benefits After $10 copay, the plan pays: –100% for lenses (single, line bifocal or trifocal or lenticular) –Up to $130 for frames (retail) –Up to $105 for contacts Once every 12 months

30 How to enroll Go to to enroll by November 30 Returning users: see instructions as your username and password will be reset New users: see instructions for creating a username and password Be prepared – Have Social Security numbers and birthdates for everyone you enroll Your date of hire and Social Security Number and phone number 30

31 Most important What you put into the system, is what you get Be careful entering your benefits, coverage information and dependent data An error may result in no benefits for 2012 or no coverage for you or a dependent Check your confirmation email Enrollment Deadline is November 30 31

32 Questions? 32

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