HUMAN RESOURCES OFFICE Canyon County, Idaho 2015 Benefits Presentation

HUMAN RESOURCES OFFICE Canyon County, Idaho 2015 Changes Joined the Government Employee Medical (GEM) Plan Plan Document has minor changes No limits on office visits with copay Appeals Process goes through GEM Plan Board of Trustees Access to medical review board

HUMAN RESOURCES OFFICE Canyon County, Idaho 2015 Changes, cont’d. Contract change effective 10/1 to match fiscal year Deductible is calendar year; Jan 1 – Dec 31 Deductible and other accumulations were sent from Meritain to BCI Pending claims prior to 10/1 are being processed by Meritain Claims on 10/1 or later are processed by BCI See FAQ’s sheet on HR Intranet page for more information

HUMAN RESOURCES OFFICE Canyon County, Idaho PPACA Changes Coverage for EEs working 30+ hours per week (eff. Jan 1, 2015) All copays must apply to a maximum OOP, including medical office visits, chiropractic visits, and Rx copays

HUMAN RESOURCES OFFICE Canyon County, Idaho Three Parts of Healthcare Preventive – No Cost to EE Exams, labs to measure wellness and basic health Visits that check your health before diagnosis is made Maintenance – Copays; Costs that may apply toward deductible Exams, labs to monitor existing health condition or disease Visits that check your health after diagnosis is made $25 Office copay Catastrophic – Costs that will likely exhaust deductible/OOP High claim(s) related to a serious injury or illness

HUMAN RESOURCES OFFICE Canyon County, Idaho Deductible 2015 Deductibles/Out of Pocket (OOP): Individual = $2,000/$4,000 (In/Out of Network) 2+ Party/Family: =$4,000/$8,000 (In/Out of Network) Once deductible is met, medical claims are paid at 100%

HUMAN RESOURCES OFFICE Canyon County, Idaho Premiums 2015 Premiums: EE only = $0 EE + Sp = $240 EE + Ch = $52 EE + Chn = $108 EE + Family = $356

HUMAN RESOURCES OFFICE Canyon County, Idaho Health Reimbursement Account (HRA) An HRA is an ER owned account, designating funds contributed by the ER to assist the EE in meeting a high deductible Funds are contributed annually and balances carry over year-to- year Only the ER can contribute to an HRA The EE cannot take the HRA with him/her when separating from CC employment

HUMAN RESOURCES OFFICE Canyon County, Idaho HRA, cont’d. CC will contribute: $400 per year for EE Only $600 per year for EE + Sp; EE + Ch; EE + Chn $800 per year for EE + Family Contributions are limited to the deductible/OOP amount HRA is administered by Professional Benefits Services (PBS)

HUMAN RESOURCES OFFICE Canyon County, Idaho How Does a HRA and a HDHP Work Together? The HRA is used to assist the EE in meeting a high deductible/OOP Funds are available on Jan. 1 st of each year until the account is equal to the plan deductible/OOP HRA funds may only be used to meet a deductible; funds cannot be used to pay copays, prescriptions or other medical expenses Once the deductible is met, the OOP is also met and future in- network costs are paid at 100%

HUMAN RESOURCES OFFICE Canyon County, Idaho HRA and FSA Work Together The HRA and the FSA can be used together to meet medical needs The HRA is used for deductible only The FSA can be used to meet a deductible, copays, prescriptions, glasses/contacts, dental costs, and qualified over-the-counter (OTC) expenses (to name a few) The FSA is administered by PBS

HUMAN RESOURCES OFFICE Canyon County, Idaho HRA and FSA Work Together HRA funds are no longer paid automatically - You are responsible for paying your provider. You will need to submit the EOB showing deductible expenses, as well as the appropriate form to PBS and they will issue you a reimbursement. Employee may choose to use HRA or FSA funds first. All FSA or HRA questions/issues now go to PBS – NOT BCI

HUMAN RESOURCES OFFICE Canyon County, Idaho COBRA Insurance coverage will end the last day of the month in which the separation from employment occurs Ex: If your last day of work is Jan 5, your coverage ends Jan 31 Ex: If your last day of work is Jan 31, your coverage ends Jan 31 You are eligible for COBRA the 1 st day of the following month

HUMAN RESOURCES OFFICE Canyon County, Idaho Idaho Health Exchange Information Starting 2014, all Americans are required to have health coverage CC employees must be covered under the CC plan unless he/she can prove health coverage under another, non-Exchange- provided health plan Spouses and dependent children may decline CC benefits and apply at the Exchange Go to YourHealthIdaho.org for more information

HUMAN RESOURCES OFFICE Canyon County, Idaho Prescription Coverage Prescription copays: $15 generic $50 formulary $75 non-formulary New Rx OOP maximum of $1500 per Individual; $3000 per FAMILY Still use CVS/Caremark with BCI; existing prescriptions were transferred to new plan

HUMAN RESOURCES OFFICE Canyon County, Idaho Other Benefits Dental – No changes to Delta or Willamette Vision – No changes If you drop CC medical coverage, you may elect to keep dental but you will lose vision coverage Chiropractic Care 18 visits per calendar year Copays apply to medical deductible/OOP

HUMAN RESOURCES OFFICE Canyon County, Idaho Other Benefits, cont’d. Employee Assistance Program (EAP) Employee or family member has 4 free counseling sessions, per issue, per year Service also offers marriage, financial and legal counsel AT A COST Contact a specialist at or or (user name = LFGsupport; password = LFGsupport1)

HUMAN RESOURCES OFFICE Canyon County, Idaho Contact Information Mutual Insurance Associates First point of contact for all medical issues/questions: Contact info: Lydie Pool, Blue Cross of Idaho (BCI) Pre-authorizations: or Online access to claims and benefits:

HUMAN RESOURCES OFFICE Canyon County, Idaho Contact Information, cont’d. Professional Benefits Services (PBS) Manage FSA and HRA accounts Forms – Login to review personal account information – countSummary.aspx countSummary.aspx

HUMAN RESOURCES OFFICE Canyon County, Idaho Life Insurance 2x employee annual salary, capped at $100,000 STD coverage 30 day elimination period (must use vacation/sick balances or unpaid) Day 31 – 180 salary paid at 67% LTD coverage Transition on Day 181 through age 65, depending on disability Employer Paid = No cost to Employee

HUMAN RESOURCES OFFICE Canyon County, Idaho Important Reminders!! Remember to give your new insurance card to your medical providers and pharmacies. All FSA forms are due back no later than NOVEMBER 15 th. Individual benefits meetings will be held October 15 th – 24 th. Please Michelle Britain at to schedule an

HUMAN RESOURCES OFFICE Canyon County, Idaho QUESTIONS?