H.B. Fuller Company 2009 Open Enrollment: Helping you Buy Well, Use Well, Be Well October, 2008.

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Presentation transcript:

H.B. Fuller Company 2009 Open Enrollment: Helping you Buy Well, Use Well, Be Well October, 2008

2  An overview of your plan options for 2009  Market 400  Value 750  High Deductible Health Plan (HDHP) with a Health Savings Account (HSA)  Key differences between plan options  Tools and resources to find the information you need  How and when to enroll Today’s Discussion PURPOSE OF TODAY’S MEETING: To help you understand your new choices in medical plan options

3 Market 400Value 750HDHP w/ HSA Deductible $400 Single $800 Family $750 Single $1,500 Family $2,000 Single $4,000 Family Fuller contribution to HSA N/A $500 Single $1,000 Family (active employees only) Out of pocket maximum $1,500 Single $3,000 Family $3,000 Single $6,000 Family Same as your deductible Preventive care (in-network only) 100% Office visit copay $30 N/A Medical Plan Options Summary

4 Market 400Value 750HDHP w/ HSA Pharmacy Generic Brand Non-formulary Specialty You pay 20% with: Minimum Maximum $10 $20 $20 $40 $40 $80 $80 $160 You pay 20% with: Minimum Maximum $10 $20 $20 $40 $40 $80 $80 $ % after deductible Coinsurance 80% after deductible 100% after deductible Out-of-network coverage 60% (deductible and OOP max doubled) 100% - no network restrictions Premium (M onth) Employee Employee + 1 Family $79.80 $ $ $57.80 $ $ $54.80 $ $ Medical Plan Options Summary (cont.)

5  This option is the most similar to what you have today, with the deductible and out–of- pocket maximum adjusted to be at the mid- point of the market. As this option has the lowest deductible and out-of-pocket limit, it carries the highest premium contribution.  Pharmacy: 20% member copay with a min/max of: Key Features of Market 400 Deductible – $400 single $800 family Out of Pocket - $1,500 single $3,000 family  Office visit copay -- $30  Preventive care 100% in-network only  Deductible and coinsurance applies to X-ray and imaging, inpatient and outpatient hospital, emergency room (+$75 copay) and durable medical equipment  Office visit, pharmacy and emergency room copays do not apply to deductible or out-of-pocket maximum. Generic – $10/$20 Brand – $20/$40 Non-Formulary Brand – $40/$80 Specialty Pharmacy – $80/$160

6  The other plan features are identical to the Market 400. Eligible expenses are paid in the same manner in both options.  Office visit copay -- $30  Preventive care – 100% in-network only  Pharmacy: 20% member copay with a min/max of: Generic – $10/$20 Brand – $20/$40 Non-Formulary Brand – $40/$80 Specialty Pharmacy – $80/$160  Deductible and coinsurance applies to X-ray and imaging, inpatient and outpatient hospital, emergency room (+$75 copay) and durable medical equipment  Office visit, pharmacy and emergency room copays do not apply to deductible or out-of-pocket maximum. Key Features of Value 750 Choosing a higher deductible is similar to the decision you make when you buy car insurance. You balance what you can afford to fix yourself vs. what you want your insurance to cover. It is always more expensive when you have a low deductible.  This option lets you pay less in monthly premium. In exchange, you may need to pay a higher deductible before the plan begins to pay. Deductible -- $750, $1,500 Out of pocket limit -- $3,000, $6,000 Premium: 40% less than Market 400

7 Key Features of HBF’s HDHP with HSA This means: High Deductible Health Plan with a Health Savings Account High Deductible Health Plan  $2,000/$4,000 deductible (total family deductible must be met)  The out-of-pocket maximum matches the deductible. The plan pays 100% after the deductible is met for eligible expenses.  Same definition of eligible expenses as in Market 400 and Value 750  Prescription drugs must apply toward the deductible  Preventive care is covered at 100% in-network Health Savings Account  Employees have the option to use pre-tax dollars to fund their account up to the IRS limits. For 2009, the limits are $3,000 single/ $5,950 family. For 2009, HBF will contribute $500/ single and $1,000/ family

8  Tax-free contributions to pay for current and/or future medical expenses  No “use it or lose it”  Interest earned tax free  Investment opportunity with tax-free growth  Flexible – you choose when or whether to use the account for health care expenses  Portable – you own the account  Banking services provided by JPMorgan Chase Bank. Some fees required.  Easy access to funds through debit card Key Features of an HSA What is an HSA? It is a savings account that is owned by you and is associated with a High Deductible Health Plan

9  Includes expenses such as:  Deductibles  Coinsurance  Not covered but eligible IRS expenses  Prescription drugs  It also includes expenses for:  COBRA-continuation coverage  Health plan coverage while receiving unemployment compensation  Medicare premiums and out-of-pocket expenses  Qualified long-term care insurance Employees are responsible for keeping all receipts and records, demonstrating that HSA dollars were used for qualified health care expenses. HSA Tax-Qualified Expenses

10 HSA Eligibility Requirements to Contribute Member is not eligible to be claimed on another’s tax return 1 Member does not have benefits from another qualified health plan 2 Member is not currently enrolled in Medicare benefits 3 Eligibility

11 HSA Investment Options

12 Health Coverage Deductible HSA Preventive Care Financial stake Employer and /or employee dollars Potential rollover and / or savings / investment incentives 100% coverage for preventive care services based on age and gender as recommended under U.S. guidelines Peace of mind Out-of-pocket maximums Clearly defined out-of-pocket potential Option to reimburse from account Financial stake How the HDHP with HSA Works

13 Len -- Year One – Note: Assumes all in-network care. Preventive Care$750 HSA funded$2,000 Non-Preventive 3 Physician’s visits$ Prescriptions 840 $1,200 Health Coverage Employee Pays$0 Health Plan Pays $750 Remains in HSA for 2 nd year $800 HSA Pays$1,200 Preventive Care: 100% $750 Health Coverage 100% Coinsurance Max OOP $2,000 Health Coverage $800 Remaining $1,200 HSA Paid $1,200 $2,000 HSA $2,000 Deductible Example with Moderate Utilization

14 Len – Year Two – Moderate Utilization Health Coverage 100% Coins. Max OOP $2,000 Preventive Care: 100% $300 $900 $1900 Remaining $900 $2,000 Deductible $2,800 HSA HSA Rollover from year one $ 800 HSA funded$ 2,000 New HSA balance$ 2,800 Immunizations $ 300 Non-Preventive 5 Prescriptions $350 Lab work250 3 Physician’s visits300 $900 HSA Pays$900 Employee Pays$0 Health Plan Pays $ 300 Remains in HSA for year three$1,900 Note: Assumes all in-network care.

15 How Claims Get Filed Aetna processes the claim, applies the discounted rate and sends an Explanation of Benefits based on High Deductible Health Plan Benefits You visit the doctor Doctor sends bill to Aetna You receive a bill from the provider You decide whether or not to use HSA funds You pay the doctor

16 Market 400/Value 750  Member copay is 20% ($20min/$40 Max)  You pay $25  The plan pays $100 HDHP and HSA  $125 applies to the deductible  You pay $125 at the pharmacy  You decide when or if you get reimbursed for the $125 Participating Pharmacy Brand Rx- $125 Claim Payment Comparison

17 Claim Payment Comparison In-Network Preventive Care Office Visit- $150 Contracted Rate Market 400/Value 750  Plan pays 100%  You pay nothing HDHP and HSA  Plan pays 100%  You pay nothing

18 Claim Payment Comparison In-network Hospital Stay- $4,000 Contracted Rate Market 400 Option  You pay $400 deductible plus 20% of the $3,600= $720  Total member responsibility is $1,120  Plan pays $2,880 Value750 Plan  You pay $750 deductible plus 20% of the $3,250= $650  Total member responsibility is $1,400  Plan pays $2,600 HDHP with HSA Individual Coverage  You pay $2,000* deductible  Plan pays $2,000 Family Coverage (2 or more people on the plan)  Plan applies $4,000 toward deductible  You pay $4,000*  Next claim will be paid at 100%. *You decide when and if to get reimbursed for any portion available in the HSA

19 Important things to consider when making your choice:  Understand how the deductible works  Individual vs. family  What counts, what doesn’t  Annual premium difference – do the math! If you are considering the HSA, here are additional considerations:  Prescription coverage – You pay 100% up to the deductible  Tax advantaged, portable savings. Great for retiree medical! Key Differences

20 For help in choosing the right medical plan option  Read newsletters and Enrollment Guide  Visit the Aetna website and sign up for Aetna Navigator  Try the Plan Selection and Cost Estimator Tool  Use Aetna’s Cost Estimator to determine cost of care  For “in-person” help, call  the HBF Benefits Connection (formerly FlexPlus)  Aetna Tools for Choosing a Medical Plan

21  To enroll online or by phone, you will need:  your 6-digit employee ID (on your pay stub)  Your PIN (Unless changed, PIN is last four digits of SSN)  Either elect or waive coverage for each available category  Print and review confirmation at end of session  Confirmation also sent to you by mail. Confirm elections, send in any additional information required and correct errors within 10 days by calling (no corrections online after Nov 11) How and When to Enroll Enroll October 29 to November 11 There are no extra “grace days” this year! You MUST enroll in Medical to have coverage 1/1/09

22 Thank you for your time! Questions?

23 Appendix

24 Why Changes Are Being Made  Assure benefits program is competitive at mid-point to the market  Provide choice to employees  Consolidate vendors in order to:  Offer same benefits to all employees  Better maximize value  Reduce administrative cost and complexity  Adjust contribution and rate setting processes to:  Better manage high cost of program  More fairly share costs between employees and retirees  Involve employees in data-driven decisions  Build a Culture of Health