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School Board of Highlands County -Insurance Update for 2014- 1.

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Presentation on theme: "School Board of Highlands County -Insurance Update for 2014- 1."— Presentation transcript:

1 School Board of Highlands County -Insurance Update for 2014- 1

2 2 Step 2 Your Contribution Single $1,500 Family $3,000 (your responsibility) Step 1 Base Health Reimbursement Arrangement (HRA) Fund* SBHC Single $1,500 Family $3,000 Step 3 Health Plan In-Network FLORIDA BLUE pays 70% You pay 30% Preventive Care covered 100% (In-Network Only) Step 1 + Step 2 Deductible Single $3,000 Family $6,000 Review - Components of the HRA Health Plan IMPORTANT NOTES: 1.HRA fund available for Medical Claims and Pharmacy Claims. 2.Unused funds will ROLLOVER from previous year to a maximum of $5,000-single and $10,000- Family. 3.Out-of-Pocket Maximum includes Deductible Step 4 Out-of-Pocket Maximum Single $5,800 Family $11,600 (100% medical coverage) HRA Plan

3 HRA Fund & Deductibles Compared Renewal Deductible -$3,000 Renewal HRA Fund Pays -$1,500 Deductible -$4,000 HRA Fund Pays -$2,000 Renewal Deductible -$6,000 Renewal HRA Fund Pays -$3,000 Single Plan Family Plan Current Year/CIGNA 2014/ Florida Blue(Proposed) Deductible -$2,000 HRA Fund Pays -$1,000 3

4 4 FLORIDA BLUE Health Plan for 2014: The HRA fund increases:  From $1,000 to $1,500 for Single coverage  From $2,000 to $3,000 for Family coverage The deductible increases:  From $2,000 to $3,000 for Single coverage  From $4,000 to $6,000 for Family coverage  Coinsurance Changes from 80% to 70% We now have an Out-of-Network Benefit Preventive care, lab work, x-ray benefits, etc. continue to be covered at 100% The dependent coverage deductions will remain the same

5 Claim Processing Change: Beginning on January 1,2014: All Covered Employees will have a debit card to be used for prescription purchases only. All Physician visits and other services will be processed using the Auto Pay feature offered by Florida Blue. The Providers will be paid directly usually within 3 days. One difference with the Auto Pay is that the Providers will not know your HRA Fund Balance. * A Mobile Application for Cell Phones is available that will give you access to the HRA Fund Information. 5

6 Prescription Coverage *RETAIL – 30 Day Supply Cigna Florida Blue In-Network OnlyIn-NetworkOut-of-Network Tier 1 - Generic$15 copay after deductible $10 copay after deductible 50% after plan deductible Tier 2 – Preferred Brand 40% after plan deductible, subject to a minimum of $20 and a maximum of $50 $50 copay after deductible 50% after plan deductible Tier 3 – Non-Preferred Brand 50% after plan deductible, subject to a minimum of $40 and a maximum of $100 $80 copay after deductible 50% after plan deductible Preventive GenericCovered at 100% with no copayment or deductible Similar List Covered at 100% with no copayment or deductible N/A 6 Medical Pharmacy Monthly In-Network OOP Max (Provider-Administered Rx) $200 In-Network 30% (No DED) Out-of-NetworkDED + 50%

7 7 Preventive Care – Know Your Numbers! Schedule your annual physical – wellness exam – Post Card Reminders were mailed first week of July – Annual Wellness Exam is covered by Cigna at 100% if a Network Provider is used. You are covered by Cigna until 12/31/13. Know Your Numbers! Ask your doctor for your results of your associated preventive care lab work: Total Cholesterol HDL Cholesterol Blood Pressure – Systolic/Diastolic Height Weight Waist Circumference

8 Health Assessment Campaign Employees are to take their annual Health Assessment online at www.mycigna.com between 8/1/13 – 9/30/13www.mycigna.com Computer Lab Hours – Available if anyone needs a computer or assistance Each Monday in August and September at the District Office 2:30 – 4:30pm with the exception of 8/12/13 and 9/2/13. 8

9 Flexible Spending Account (FSA) - Optional  Employee enrolls during Open Enrollment and elects an annual amount for their FSA account. Contributions are made as a payroll deduction in equal amounts each pay period (2013 Health Care FSA annual max. = $2,500)  FSA account reimburses the employee for out-of-pocket expenses incurred in that plan year via reimbursement requests sent to CIS, once the HRA fund is expended  Employee can be reimbursed for eligible out-of-pocket health/dental expenses up to their annual elected amount, before the full contributions have been made  Plan annual amount carefully based on known medical expenses to be incurred in the calendar year. If all account contributions are not used (reimbursed), remaining contributions are forfeited.  Employee receives tax advantage because FSA contributions reduce taxable income  Employee enrolls during Open Enrollment and elects an annual amount for their FSA account. Contributions are made as a payroll deduction in equal amounts each pay period (2013 Health Care FSA annual max. = $2,500)  FSA account reimburses the employee for out-of-pocket expenses incurred in that plan year via reimbursement requests sent to CIS, once the HRA fund is expended  Employee can be reimbursed for eligible out-of-pocket health/dental expenses up to their annual elected amount, before the full contributions have been made  Plan annual amount carefully based on known medical expenses to be incurred in the calendar year. If all account contributions are not used (reimbursed), remaining contributions are forfeited.  Employee receives tax advantage because FSA contributions reduce taxable income 9


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