Presentation is loading. Please wait.

Presentation is loading. Please wait.

Employee Benefits SAINT LOUIS UNIVERSITY 2011 Annual Enrollment.

Similar presentations

Presentation on theme: "Employee Benefits SAINT LOUIS UNIVERSITY 2011 Annual Enrollment."— Presentation transcript:

1 Employee Benefits SAINT LOUIS UNIVERSITY 2011 Annual Enrollment

2 Benefits Overview—Coverages Offered  Medical/Pharmacy  Voluntary Dental  Employee Term Life and Accidental Death & Dismemberment (AD&D)  Voluntary Term Life  Voluntary AD&D  Long Term Disability  Flexible Spending Accounts  Business Travel Accident S:\EB\Clients\STLLU08\EE Communications\2010\Enrollment Presentation.pptx 1

3 Medical/Pharmacy Benefits Annual Enrollment 2011

4 Highlights Effective January 1, 2011  The Vitality™ Wellness Program –Save on premium and earn rewards! –Health screenings are needed to participate in the Vitality program  Medical changes –Lifetime maximum on both plans will be unlimited –Preventive care is covered at 100% –Pricing will be done on four tiers: Employee, Employee & Spouse, Employee & Child(ren), or Family  No Dental plan design changes  Eligibility Changes: –You can now cover adult children to age 26 regardless of student or marital status on both the medical and dental insurance  Express Scripts –Ninety-day prescriptions will no longer be available at retail pharmacies but can still be obtained via mail order  Flexible Spending Accounts (FSAs) –Over-the-counter (OTC) Medication will no longer be reimbursable under FSA programs due to Federal health care reform S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 3

5 Primary PlanPlus Plan SLUCareIn-Network Out-of- NetworkSLUCareIn-Network Out-of- Network Deductible Individual$250$500$1,000$0$250$750 Family$500$1,000$2,000$0$500$1,500 Coinsurance0%20%40%0%10%40% Out-of-Pocket Maximum (includes deductibles) Individual$1,250$2,500$5,000$0$1,250$4,750 Family$2,500$5,000$10,000$0$2,500$9,500 Physician Office Visits Primary Care$10 copay20% after deductible 40% after deductible $10 copay10% after deductible 40 % after deductible Specialist Care$20 copay Inpatient Hospital 10% after deductible 20% after deductible 40% after deductible 0% after deductible 10% after deductible 40% after deductible Emergency Room $100 copay Urgent Care Center $50 copay UnitedHealthcare Plans S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 4

6 UnitedHealthcare Plans S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx Primary PlanPlus Plan Express Scripts Retail Network Pharmacy (34-day supply) Mail Order (90-day supply) Express Scripts Retail Network Pharmacy (34-day supply) Mail Order (90-day supply) Tier 1$10$20$10$20 Tier 2$25$50$25$50 Tier 3$40$80$40$80 5  For more information on your prescription drug coverage, please visit:

7 Copays  You only have copays in THREE scenarios: 1)Physician office visits for SLUCare ONLY!  Both the Primary and Plus plans offer $10 primary care physician and $20 specialist office visit copays.  All other UHC in-network physician office visits are billed at the discounted rate and apply to your deductible and coinsurance 2)Urgent Care and Emergency Room Facilities  Both the Primary and Plus plans offer $50 urgent care facility and $100 emergency room copays both in- and out-of-network. 3)Rx Drugs  Both the Primary and Plus plans offer copays for Rx drugs: 6 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx Primary PlanPlus Plan RxRetail (30 Days)Mail Order (90 Days)Retail (30 Days)Mail Order (90 Days) Generic$10$20$10$20 Preferred Brand$25$50$25$50 Non-Preferred Brand $40$80$40$80

8 Illustrative Medical Scenario  You visit a SLUCare doctor at a UHC-contracted hospital for an inpatient surgery; $1,250 in Physician charges and $5,000 in facility charges (after UHC discounts) –PRIMARY PLAN  Doctor’s Charges: $250 deductible (SLUCare specific, cross applies to in-network deductible), then 10% coinsurance (10% x $1,000 = $100) –$250 + $100 = $350  Facility Charges: $500 deductible (UHC in-network deductible, cross applies with SLUCare deductible; only $250 remains), then 20% coinsurance (20% x $4,750 = $950) –$250 + $950 = $1,200  TOTAL = $1,550, leaving $950 on your out-of-pocket maximum ($900 on the SLUCare specific out-of-pocket maximum) –PLUS PLAN  Doctor’s Charges: $0 deductible (SLUCare specific), 0% coinsurance –$0 + $0 = $0  Facility Charges: $250 deductible (UHC in-network deductible), then 10% coinsurance (10% x $4,750 = $475) –$250 + $475 = $725  TOTAL = $725, leaving $525 on your out-of-pocket maximum 7 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx

9 Tips For You to Help Save Money  As an employee, you can take ownership in you and your family’s health care  Consumers can control costs by: –Using less expensive and more efficient providers (i.e., in-network) –Using appropriate providers (i.e., urgent care versus emergency room for non-emergencies) –Requesting generic prescriptions or prescriptions on lower tiers when available –Using mail order for maintenance prescriptions S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 8

10 UnitedHealthcare’s Member Website  Find participating providers  Check claim status and history  Learn more about your benefits  Track deductibles, out-of-pocket expenses and lifetime maximums  Estimate and compare treatment costs S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 9

11 Medical Payroll Deductions PrimaryPlus Monthly WITH Wellness WITHOUT Wellness WITH Wellness WITHOUT Wellness Single$39.62$59.62$68.97$88.97 Employee & Spouse$236.98$256.98$298.63$318.63 Employee & Child(ren)$214.41$234.41$270.19$290.19 Family$338.55$358.55$426.61$446.61 Subsidy Coverage$0.00$20.00 Bi-Weekly WITH Wellness WITHOUT Wellness WITH Wellness WITHOUT Wellness Single$18.29$27.52$31.83$41.06 Employee & Spouse$109.38$118.61$137.83$147.06 Employee & Child(ren)$98.96$108.19$124.70$133.93 Family$156.25$165.48$196.90$206.13 Subsidy Coverage$0.00$9.23 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 10

12 Voluntary Dental Benefits Annual Enrollment 2011

13 Voluntary Dental Benefits  Coverage will continue through Delta Dental  Choose between three dental plan options  Benefits will remain the same for 2011  Contributions increasing 7% S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 12

14 Voluntary Dental Plan—Delta Dental S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx Flex OptionBasic PlusBasic In-NetworkOut-of-Network In-Network Only Deductible Individual$50 $25 Family$150$50$75 Calendar Year Maximum Per person$1,000 $750 Preventive Care 0% no deductible Basic Restorative Care 10% after deductible 30% after deductible Major Restorative Services 40% after deductible 60% after deductible 65% after deductible Not covered Orthodontia Lifetime maximum (per person)$1,000 Not covered Orthodontia 50% For adults and children 60% For adults and children 50% For children only Not covered 13

15 Dental Payroll Deductions FlexBasic PlusBasic Monthly Single$31.01$20.24$14.45 Two-person$60.70$38.42$28.08 Family$103.91$65.36$50.23 Bi-Weekly Single$14.31$9.34$6.67 Two-person$28.02$17.73$12.96 Family$47.96$30.17$23.18 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 14

16 Flexible Spending Accounts Annual Enrollment 2011

17 Flexible Spending and Dependent Care Accounts  Administration will remain with ConnectYourCare  You must make a new election for the 2011 Plan Year; current elections cannot be carried forward  Due to National Health Care Reform, as of January 1, 2011, over- the-counter (OTC) medicines are no longer eligible for purchase with an FSA unless you have a prescription from your doctor  You can continue to use your FSA funds to purchase OTC items that are not considered a medicine or drug (e.g. bandages, splints, contact lens solutions, etc.)  Take these new rules into consideration when estimating the dollar amount you will put in your FSA in the upcoming plan year S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 16

18 Flexible Spending and Dependent Care Accounts  Annual maximum for the health care FSA will remain at $5,000  Annual maximum for the Dependent Care Account Contribution will remain at $5,000 ($2,500 if married and filing separate returns)  For the health care FSA, your total election amount less previous reimbursements is available at the time of transaction  For the Dependent Care FSA, only the cash balance in your account is available at the time of transaction  You cannot roll over unused balances from one year to the next; carefully estimate your expenses for the next plan year… especially in light of the new OTC rules S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 17

19 Flexible Convenience Card  Can be used at authorized vendors (medical facilities, hospitals, pharmacies, etc.)  Allows direct payment at time of service  If you have a prescription for an OTC medication, you must pay out-of-pocket (NOT with your FSA debit / convenience card) and submit a manual claim requesting reimbursement  Cards are good for three years!  So, if you currently have a Flexible Convenience Card, hold on to it! It will be reloaded with any election you make for 2011! S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 18

20 Eligible Traditional Medical FSA Expenses  Copays, co-insurance and deductibles for medical, prescription and dental plans  Eye exams, contacts and eyeglasses  Laser eye surgeries  Hearing aids  Over-the-counter medical supplies (but not medications) –Bandages, splints, contact lens solution, etc.  Insulin  Some expenses not covered by your health care plan S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 19

21 Advantages of FSAs—Tax Savings Example Without FSA Pretax SavingsWith FSA Pretax Savings Annual Base Pay $25,000 Health Care Account Expenses -$0-$1,000 Dependent Care Account Expenses -$0-$2,000 Annual Taxable Income $25,000$22,000 Estimated Federal Income Taxes -$3,750-$3,300 After-tax Cost of Expenses -$3,000-$0 Annual Net Pay $18,250$18,700 Tax Savings $450 Assumes individual filer w/federal income tax rate of 15%; example does not include state, city, or other taxes S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 20

22 Annual Enrollment 2011 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx

23 Elections Are Binding For The Plan Year Unless There Is A Life Status Change  Marriage  Birth/adoption  Divorce  Death  Change in employment status  Change in dependent status Life status change allows you to make benefit election changes and adjust your FSA elections Benefits department must be notified within 31 days of life change S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 22

24 What Next?  Enrollment season is November 1 st through 30 th  All employees must enroll or make changes through Banner Self- Service  Update beneficiary information if necessary  Return all materials to the benefits office no later than Tuesday, November 30 th, 2010 S:\EB\Clients\SLU08\EE Communications\2010\Enrollment Presentation.pptx 23

Download ppt "Employee Benefits SAINT LOUIS UNIVERSITY 2011 Annual Enrollment."

Similar presentations

Ads by Google