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OPEN ENROLLMENT FOR HEALTH INSURANCE AND VOLUNTARY EMPLOYEE BENEFITS Highlights for 2011-12 School Year.

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Presentation on theme: "OPEN ENROLLMENT FOR HEALTH INSURANCE AND VOLUNTARY EMPLOYEE BENEFITS Highlights for 2011-12 School Year."— Presentation transcript:

1 OPEN ENROLLMENT FOR HEALTH INSURANCE AND VOLUNTARY EMPLOYEE BENEFITS Highlights for 2011-12 School Year

2 Highlights for 2011-12  The purpose of this presentation is to highlight important elements and changes to the Chandler employees’ benefit plans for 2011-12 school year.  Decisions regarding insurance are critical and medical insurance can be complicated.  This brief presentation does not eliminate the need to read the benefit guide thoroughly (district website) and ask questions prior to making a decision.  More in-depth presentations are offered to further assist you in the benefit-related decisions.

3 Open Enrollment – Deadline April 29  Open Enrollment is the only time to make changes to your benefit plans.  Because some of your benefits are pre-tax, the IRS does not allow changes outside open enrollment unless you have a qualified life status changes, such as marriage, birth/adoption, or a change in dependent/spouse employment status which impacts benefits.  Open Enrollment for Chandler employees begin March 28 th and ends April 29 th.

4 District Contribution to Eligible Employee  In addition to salary, the district provides an annual benefit contribution which eligible employees may use to pay for their selected medical plan.  The medical benefit contribution for eligible employees is $4752 for the 2011-12 plan year.  Employees may have to pay part of their benefit costs if the insurance premium for their selected plan exceeds the contribution.

5 Changes for 2011-12  The district will continue to offer three plans.  Choice Plus PPO plan with co-pays  Two High Deductible with Health Savings Account  Each eligible employee also will receive an insurance policy for term life insurance and Long Term Care.  Life insurance policy - $50,000.  Long Term Care insurance to help pay for nursing or assisted living expenses.  Dental is no longer “bundled” with any of the plan choices.  To offset premium increases due to normal medical inflation, dental insurance will be offered as a voluntary benefit, to be paid at employee cost.

6 Other Changes  Young adult children will be able to stay on their parent’s insurance until the age of 26, as long as they are not covered under another insurance plan.  Over the Counter Drugs may not be purchased using HSA or Flex funds.  Preventive Services offered to Traditional plan enrollees will be paid at 100% with no co-pay.

7 Choice Plus PPO Plan  Copays are $25.00 per visit.  Specialist copays are $35.00 per visit.  Copays do not count toward satisfying your deductible.  Plan year deductible is $1000 per individual ($2000 per family).  This is an increase from $750 in 2010-11.  After the individual meets his deductible, insurance pays 80% of the cost and the plan member pays 20%.  Out of network is 50/50% split.  If medical expenses exceed $2000 (out of pocket max) in a plan year, insurance pays 100% of the cost.  Copays continue even after plan member meets the out of pocket maximum for the year.

8  2200 CUSD employees are currently in a HSA plan. 650 employees remaining in the Choice Plus PPO Plan.  Plan performance was poor in 2010-11 requiring a substantial premium increase.  Premium increase will be offset by: Offering dental as a voluntary benefit Increasing the plan year deductible from $750 to $1,000  2011-12 may be the last year Choice Plus PPO plan is offered  2011-12 Annual Premium -$7,545.00  Per pay period contribution $126.95 2011-12 Premium District Contribution Balance (out of pocket)Per Pay Period Deduction $7545.00$4,752.00$2,793$126.95 Choice Plus PPO plan for 2011-12

9 Pharmacy for Choice Plus PPO Plan Benefit Retail Network Pharmacy For up to a 31 day supply Retail Non- Network Pharmacy For up to a 31 day supply Home Delivery Network Pharmacy For up to a 90 day supply Tier 1 $10 $25 Tier 2 $35$30$87.50 Tier 3 $50 $125  Member will need to meet the plan year pharmacy deductible of $100, before copays will apply.

10 Highlights of Health Savings Account  In general, you can participate in a Health Savings Account if you:  Do not have coverage under any non-high deductible health plan, such as your spouse’s traditional plan.  Are not enrolled in Medicare due to age or disability.  Features of Health Savings Accounts  Employee’s Own Personal, Interest-Bearing Bank Account  Distributions are tax-free if used for qualified health care expenses for: Yourself Your spouse And/or your dependents  Your spouse and dependents do not need to be covered by the High Deductible plan in order for you to use health savings account funds to pay for their out-of-pocket health care expenses.  Unused money rolls over each year and stays in employee’s account.  You take it with you when you leave your employment with Chandler.

11 High Deductible Plans with Health Savings Account  Premium is less than district contribution.  Balance of district contribution is deposited in the employee’s health savings account.  Preventative Services are covered at 100%  There are no co-pays, with the exception of preventative medications.  Preventative medications co-pays will not count toward your plan year deductible.  The plan member must meet the deductible before co-insurance begins.  After the plan member meets the deductible, insurance pays 80% of the cost and the employee pays 20%.  Out of network is 60/40% split.  If medical expenses exceed the plan year out of pocket max, insurance pays 100% of the cost.  The plan member may also contribute tax free to his health savings account.

12 2011-2012 HSA 1400 Plan  Previously 1300 Plan.  Plan year deductible increase from $1300 to $1400.  Out of pocket maximum will remain at $3800.  No dental bundled with plan.  Dental offered as voluntary plan only.  HSA contribution will increase to $1300.  One-time Wellness Incentive  Health Risk Assessment (HRA) $250 District Contribution 2011-12 Premium HSA DepositWellness Incentive (one time) TOTAL HSA Deposit $4,752 $3,452$1,300 $250$1,550

13 Health Risk Assessment (HRA)  Found at: www.myuhc.comwww.myuhc.com  52-question assessment; takes approximately 15 minutes to complete.  Provides immediate feedback on the current state of your health.  Your responses are used to help create a customized online experience.  Identify your personal health needs and “lifestyle score”  Learn healthy habits  Access health improvement resources  All information is confidential.  Individual data is never provided to the employer or used to make individual employment or benefit decisions.

14 2011-2012 HSA 2600  Previously the 2550 Plan.  Embedded Deductible (Family Coverage).  Plan deductible increase from $2550 to $2600.  Out of Pocket Max will remain at $4550.  HSA contribution remains $2401.  One-time Wellness Incentive  Health Risk Assessment (HRA) $250 District Contribution 2011-12 Premium HSA DepositWellness Incentive (one time) TOTAL HSA Deposit $4,752 $2,351$2,401 $250$2651

15 Pharmacy for HSA Plans Benefit Retail Network Pharmacy For up to a 31 day supply Retail Non- Network Pharmacy For up to a 31 day supply Home Delivery Network Pharmacy For up to a 90 day supply Tier 1 $10 $25 Tier 2 $30 $75 Tier 3 $50 $125  Drugs on preventive list are covered with copays.  Complete list of preventive drugs on district website.  Copays for preventative medication will not be applied toward your plan year deductible  If medication is not on preventive list, plan member must meet deductible before copays apply.  Prescriptions are paid at 100% after member meets maximum out of pocket maximum.

16 Medical Insurance Rates (Eligible Employees 30+ Hours per Week) Traditional PPO HSA 1400 High Deductible with Health Saving HSA 2600 High Deductible with Health Savings District Contribution$4752 Premium (Cost) for Employee $7545$3452$2351 Difference-$2793+$1300+$2401 Bi-weekly Payroll Deduction over 22 pays $126.9500 Bi-annual Contribution to Employees’ Health Savings Account for Medical Expenses n/a$650 per semester for total of $1,300 per year $1,200.50 per semester for total $2,401 per year Voluntary maximum employee contribution $1,750$649 Wellness Incentive (Health Risk Assessment) $250

17 Dental Vision Additional Life Insurance for You or Dependent Additional Long Term Care Insurance for You or Family Member Short Term Disability Flexible Spending Accounts Voluntary Plans and Benefits

18 Voluntary Dental  Core Plan  (6 month waiting period for major services)  No Orthodontics  Preventative 100%  Basic Services - 70% Excludes sealants  Major Services - 40%  Calendar Year Max - $1500  Per Pay period $16.37 per pay for employee only  Premier Plan  Orthodontics Lifetime Max - $750  Preventative - 100%  Basic Services - 80%  Includes sealants  Major Services - 50%  Calendar Year Max - $1500  Per Pay period $18.61 per pay employee only

19 Voluntary Vision  Covers eye exams once every year.  Lenses are covered 100% after a $20 co-pay.  Frame allowance $130.  Contacts in lieu of lenses and frames allowance $130.  Premium based on 22 payroll deductions.  $ 4.29* - Employee Only $ 6.21* - Employee + 1 $ 6.21* - Employee + 1 $11.14* - Employee +2 $11.14* - Employee +2

20 Voluntary Life Insurance  Each eligible employee receives $50,000 life insurance.  Employees can purchase additional voluntary life insurance coverage, premiums based on age and amount of coverage  Spouse/child coverage available.  Employees not currently enrolled in voluntary life insurance coverage, or wish to increase their current coverage level during this year’s Open Enrollment must provide Sun Life with evidence of good health by completing the Sun Life Evidence of Insurability form.

21 Short Term Disability Insurance  Continuing employees wishing to enroll for the first time will need to provide Evidence of Insurability.  Individuals currently covered can move up one step without EOI.  The policy does not pay for disabilities within 12 months of your initial enrollment plan, if you received medical treatment, consultation, care or services (including diagnostic measures), or took prescribed drugs or medicines for the disabling condition during the 12 months prior to your initial enrollment date.  To be eligible during pregnancy, you cannot be pregnant prior to the benefit effective date.  The plan provides monthly benefits ranging from $360 to $5,000, based on your annual salary, not to exceed 66 2/3% of your salary.

22 Flexible Spending Account  A NEW FORM MUST BE COMPLETED EVERY SCHOOL YEAR  If you are enrolled in an HSA plan you are only able to use your medical flex spending account for dental and vision expenses.  When making flex account elections please keep in mind that if you do not use the funds by June 30, 2011 you will forfeit all remaining money in the account.  Most over the Counter medications are no longer eligible expenses, please visit www.basiconline.com to find the most current list of eligible expenses. www.basiconline.com

23 Long Term Care Insurance  Effective June 1, 2011  Current CUSD employees are guaranteed issuance, regardless of health status, during the initial open enrollment period: March 28 - April 29, 2011  No evidence of insurability required during this period.  No open enrollment or increase in coverage in future years without evidence of insurability.  Basic coverage provided at district cost.  Employees may purchase additional coverage for self or spouse. First deduction for additional coverage will be on 08/11/2011. Premiums due for the month of June, July and August will be deducted in your 08/11/2011 paycheck.

24 Long Term Care Insurance  Individuals retiring or resigning will be billed directly.  As long as you pay you will keep your coverage  If you miss your payment you will be canceled. You will not be able to purchase at the group rate once you have been canceled.  Website: http://w3.unum.com/enroll/CUSD  All Enrollment forms  Calculator, which will tell you how much your monthly cost will be for additional coverage.

25 Things You Need to Know  Complete explanation of benefits is on the district website  Summary Plan Documents with benefit details provided by UHC.  When you enroll in one of the district plans, you have access, at no additional cost, to United HealthCare 24-hour confidential help line called Care 24.  Nurse line is staffed with nurses, counselors, and more to help you with any problem ranging from medical to personal, legal, and financial.  UHC website  View Claims  View HSA Balance  Find Providers in network  Price Medications and procedures  Pay your medical invoices  Medco website – pharmacy online

26 Open Enrollment Procedure  On-line Open enrollment  Should be working by Friday April 1, 2011  Everyone must enroll  Must be received by April 29, 2011  Benefit Guide and prices are available on CUSD Website


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