Presentation on theme: "1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest."— Presentation transcript:
1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest
2 Meeting Overview Medical Insurance Health Care Reform changes Base PPO Plan Buy Up PPO Plan Lumenos H.S.A. Plan Good News! No change to Employee Contributions Dental Insurance- Plan Design Employee Contributions Life/AD&D and Long Term Disability- No Changes Flexible Spending Account Open Enrollment Procedures and Deadlines
3 Health Care Reform Changes that will go into place at renewal- No lifetime maximum (current $5,000,000) or unreasonable annual limits on essential benefits Dependents are now eligible for health insurance up to age 26 Preventive care on all plans will be covered at 100% with no copay or deductible (H.S.A. plan currently already has this coverage)
4 Base PPO Plan In Network- Anthem National Blue Card Network Calendar Year Benefits Deductible- Single $1,000; Family $2,000 Coinsurance- 80% Anthem; 20% Member Out of Pocket Maximum- Single: $3,000; Family $6,000 Office Visit Copay- $25 copay Emergency Room- $100 copay Urgent Care- $50 copay Prescription Drugs- $100 deductible per person per calendar year then $10 Tier 1; $30 Tier 2; $50 Tier 3 Lifetime Maximum- Unlimited This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
5 Buy Up PPO Plan In Network- Anthem National Blue Card Network Calendar Year Benefits Deductible- None Coinsurance- 90% Anthem; 10% Member Out of Pocket Maximum- Single: $1,000; Family $2,000 Office Visit Copay- $20 copay Emergency Room- $50 copay Urgent Care- $35 copay Prescription Drugs- $10 Tier 1; $25 Tier 2; $45 Tier 3 Lifetime Maximum- Unlimited This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
7 Your Lumenos In Network H.S.A.Plan Details At-a-Glance Lumenos PlanSingle CoverageFamily Coverage PreventiveNationally recommended services No cost, no deduction from HSA with in- network providers Traditional Health Coverage Annual Calendar Year Deductible- You will be given credit for any deductible met from 1/1/11 through 6/30/11 (if you are currently in the Base PPO plan) $3,000 $6,000 Non- Embedded Medical Services Prescription Copays after the deductible is met 100% for In-Network Services Tier 1: $10; Tier 2: $30; Tier 3 $50; Tier 4: 25% HSA You can use the funds from your Health Savings Account to help satisfy your annual deducible Employer’s 1 st Year allocation (Half will be funded 7/1/11 and the other half 1/1/12) Annual IRS HSA contribution maximum combined between the employer and the employee $1,000 $3,050 $2,000 $6,150 This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
9 Lumenos Plan with an HSA With the Lumenos plan, you have a high deductible medical plan coupled with a Health Savings Account (HSA) You can fund your HSA with pre-tax payroll contributions or post-tax contributions (which are deductible when you file your taxes) The money in your HSA can be used to pay for your medical care, including prescriptions that go toward satisfying your deductible Once you’ve satisfied your deductible the plan’s Traditional Health Coverage prescription copays kicks in.
10 Using Your Lumenos Plan to Get Care When you visit an in-network doctor: Show your ID card at the time of service Typically you pay nothing at the time of service. Your provider will file a claim You will receive a Claim Recap showing the total cost and the “allowed” cost. Your provider will then bill you for the “allowed” cost of the service(s) If you have funds in your HSA you can pay your provider using your HSA checkbook or debit card When you visit a doctor that is not in the network: Show your ID card at the time of service You may be asked to pay at the time of services. Use your HSA checkbook or debit card to pay your provider for services (provided you have the funds available) If your provider does not file a claim on your behalf, you will need to file a claim with Anthem BCBS to ensure expenses get applied towards your out-of-pocket. You can download a claim form at anthem.com
11 Using Your HSA Plan to Get Care When you visit a pharmacy: Show your ID card at the pharmacy Until you have satisfied your annual deductible you will pay the full discounted cost of your prescription drug You can pay for your prescription at the pharmacy using your HSA debit card or checkbook as long as there are funds available in your HSA account. After the deductible is met you will pay the applicable copays of $10/$30/$50/25%.
13 Can I Use My HSA to Pay for Non-Qualified Medical Expenses? Yes, but… Any amount you spend will be considered taxable income (you will have to pay taxes on the amount used), and you will have to pay a 20% penalty on the Non-qualified expenses will not count toward your deductible Once you are 65, you can withdraw the money without penalty, but it will be considered taxable income
14 Can I Still Have an FSA? You can, if your employer offers one of the following limited purpose FSAs: A limited purpose FSA which limits reimbursements to eligible dental and vision care; or, A limited purpose high deductible FSA (LPHD FSA) provides immediate reimbursement of your dental and vision expenses as well as reimbursement of your qualified medical expenses once your deductible requirement is met
16 Making Contributions to Your HSA There are several ways you can contribute to your account: Tax-free through payroll deductions Post-tax by personal check When you file your taxes, you can make an adjustment to your gross income to receive the tax benefit You’ll receive deposit slips for your HSA in the mail Anyone may contribute to your HSA, provided the total contributions to your HSA do not exceed your maximum allowable annual limit $3,050 for individual coverage $6,150 for family coverage You can make catch-up contributions if you are 55 years of age or older ($1,000 for 2011)
17 HSA Tax Benefits Contributions made via payroll deduction are pre-tax Reduces your federal adjusted gross income (the amount you pay tax on) Contributions made by personal check are post-tax You will need to make an adjustment on your gross income when you file your taxes to receive the tax benefit If you use your HSA for a non-qualified expense (e.g. not covered services or qualified medical expenses), you will have to pay tax on the expense and are subject to a 20% penalty on the amount.
18 Am I Eligible for the HSA Plan? The IRS and the U.S. Department of the Treasury have specific rules on who can open an HSA. You can open an HSA if you: Are enrolled in the Lumenos HSA plan, because it includes an HSA-compatible health plan Are a U.S. resident and not a resident of Puerto Rico or American Samoa Are not enrolled in Medicare or another non-qualified plan Are not claimed as a dependent on another individual’s tax return Are not active military Others – refer to online health site Note: You cannot open an HSA if you have coverage under any other health plan that is not an HSA-compatible health plan.
19 Who is Holding the Funds in My HSA? A qualified financial institution will hold and invest the money. Hebrew Union has Partnered with 5/3. Services provided: Your debit card and PIN Your HSA checkbook FDIC insurance Monthly account statements Year-end tax forms *If your employer has selected a financial institution to administer your HSA that is not one of Anthem’s partner banks, or you choose to have your HSA at a different bank, you will not have access to HSA information through Anthem Customer Service or the online health site. Investment rules and fees for your account may also vary.
20 Employee Monthly Contributions Base Plan or HSA Plan The current Salary Based Tier will continue: Salary under $35,000 is charged 1.75 % for single and 3.25% for Family. Salary $35,000 to $50,000.00 is charged 2.25% for single and 3.75% for family. Salary over $50,000 – is charged 2.75% for Single and 4.25% for family. Buy Up Plan Buy Up Single = % of salary noted above plus an additional $131.04 per month Buy Up Family = % of salary noted above plus an additional $393.14 per month
21 Dental Insurance- Guardian The Dental plan design with Guardian will remain the same. In Network- Calendar Year Benefits Deductible: Single $50; Family $150 (waived for Preventive) Annual Maximum Per Person: $1,000 Preventive: Covered in Full Basic Service: Covered at 80% after deductible Major Service: Covered at 50% after deductible Orthodontia: Covered at 50% to $1,000 lifetime maximum per dependent child up to age 19 To look up a provider please log on to www.guardian.com.www.guardian.com Customer Service-1-800-541-7846 2011-2012 Monthly Employee Contributions Single: $8.31 Family: $35.79
23 What is a Flexible Spending Account or FSA? Pay expenses with tax-free money Three Accounts- Health Care, Limited Purpose (for HSA participants) & Dependent Care Voluntary election of payroll deductions Money held in your name Submit claim for reimbursement
24 Think of what you buy with your money... Deductibles Rx Drugs Copayments Day Care Eyeglasses/Contacts Lasik Surgery Dental Work OTC Provision
25 Flexible Spending Account Health Care Reimbursement Eligible Expenses- see FSA packet $7,000 Maximum limit Use worksheet to estimate total expenses Calculate total contribution Dependent Care Reimbursement Eligible Expenses- see FSA packet If married, spouse must work or attend school full-time Maximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return
26 Flexible Spending Account Limited Purpose Account Limited Purpose Flexible Spending Account is a tax savings account that reimburses employees for eligible dental and vision care expenses in conjunction with a HSA. Eligible Expenses- dental and vision only $7,000 Maximum limit Use worksheet to estimate total expenses Calculate total contribution
27 Open Enrollment Summary Health Insurance- If you do not want to switch plans your plan will automatically renew. HSA Bank Account- More information will be emailed out to the campus on how to enroll and set up your H.S.A. bank account if you enroll in the H.S.A plan. FSA- Please complete the enrollment form and turn it into the Cincinnati Benefits department If you would like to make any changes to your Dental, Life or Supplemental Life please contact HR for a change form. As a reminder there is not an open enrollment for Dental. If you would like to increase your supplemental life insurance evidence of insurability is required. You will be approved or declined based on your current health status. ALL FORMS ARE DUE TO HR NO LATER THAN JUNE 20th