Community College System of New Hampshire Employee Benefits Informational Sessions.

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Presentation transcript:

Community College System of New Hampshire Employee Benefits Informational Sessions

Informational Sessions Anthem Blue Cross and Blue Shield Health Plans – Overview and Plan Changes – Health Reimbursement Account NEW!! Compass Delta Dental: Dental Plan – Overview and Plan Changes NEW!! Vision Plan: DeltaVision® Life and Disability Benefits: The Standard Combined Services: Flexible Spending Account Questions?? 2

Documents / Disk Disk – Employee Benefit Summaries – Anthem Enrollment Kit – Compliance Documents – Information Session Presentation Documents – Anthem Lumenos POS New England Benefit Summary Anthem Lumenos national plan – available upon request – Anthem Member Savings – Compass Information – Vision Benefit Summary – Other documents provided by the Plans 3

Open Enrollment Dates: IMPORTANT Open Enrollment Dates October 28 th to November 20 th 4 Passive Enrollment – Medical Only Employee Coverage will be transitioned from current medical plan to Anthem Blue Choice NEW ENGLAND Network Employees requesting to enroll in the NATIONAL plan must make the election.

Anthem Blue Cross and Blue Shield Stay healthy with Preventive Care coverage Health Reimbursement Account provided by CCSNH to employees for payment of services that go towards the deductible In Network and Out of Network structure on the Blue Choice Point of Service (POS) plan Family plan claims for all family members go towards the deductible After the annual deductible, Traditional Health Coverage covers additional expenses An annual out-of-pocket maximum protects you from large medical expenses 5 Preventive Care 100% In-Network HRA Funded by your employer to help satisfy annual deductible Annual Deductible Traditional Health Coverage

Anthem Blue Cross and Blue Shield NETWORK: Blue Choice Blue New England o Non Network Services: Subject to Coinsurance of 30% after Deductible o Primary Care Physician is NOT Required o Services OUTSIDE the network – subject to 30% coinsurance over the deductible up ($10,000 [2x] Out of pocket) OPTION: National Network o National Network / Preferred Blue o No Referrals o NO Primary Care Physician 6

Blue Choice New England: In Network SingleFamily PreventiveNo cost No deduction from HRA with in-network providers (Non-Network preventive services subject to deductible) HRA (funded by CCSNH)$2,500$5,000 Plan Deductible$2,500$5,000 Coinsurance100% Prescriptions Mail order: (2x, 2x, 3x) Deductible then: $10 Generic, $35 Preferred Brand Name. $50 Brand Name Out of Pocket Maximum$5,000$10,000

National Plan: In Network SingleFamily PreventiveNo cost No deduction from HRA with in-network providers (Non-Network preventive services subject to deductible) HRA (funded by CCSNH)$2,500$5,000 Plan Deductible$2,500$5,000 Coinsurance100% PrescriptionsDeductible Only Out of Pocket Maximum$2,500$5,000

Health Reimbursement Account In Network Providers will bill Anthem directly and be paid directly out of the HRA account until the deductible is met Members do NOT need to submit anything to Anthem unless they visit an Out of Network Provider The HRA will cover the entire deductible for medically necessary services and covered for any services provided by an In Network Provider 9

How Does the Deductible Work? Single: Subject to the Individual deductible ($2,500). Family: Subject to the Family Deductible ($5,000). One or more members may contribute to and meet the entire Family deductible. Once the Family Deductible is met, all the members on the policy are considered to have met their deductible. Example: If a CDHP family deductible is $5,000, one person may contribute $5,000 to meet the entire family deductible OR two or more people on same plan may contribute any amount ($1,000 + $3,000 + $1,000) to equal the $5,000 family 10

Prescription Plan 1.Present your ID card when they visit a pharmacy to make sure they receive the right discount for their prescription. 2.At in-network pharmacies prescription expenses will be paid directly from the HRA. A claim will automatically be filed for the member, and the full discounted cost of the prescription will be deducted automatically from the HRA. 3.Once you’ve met your deductible and your traditional health coverage has kicked in, you’ll pay only the copay at the pharmacy, up to your plan’s annual out-of-pocket maximum. 4.If you have met your annual out-of-pocket maximum, the plan will pay 100% of the cost of your covered medications in network. 11

Earn Rewards Earn rewards in the form of gift cards for the following o Completing the MyHealth Assessment online, $50 gift card o Enroll in Health Coaching Program, $100 gift card o Graduate form Health Coaching Program, $200 gift card Other opportunities to earn gift card rewards for Tobacco Free and Healthy Weight programs Fitness Benefits: o Fitness equipment reimbursement $200 per full time employee per year or o Health Club Benefit up to $450 per full time employee per year Register on anthem.com and find specials offers at: 12

Compass Healthcare Easy to Use: SmartShopper allows members to shop online or by phone for specific health care services. Members are able to access the information needed for their procedure in a short amount of time in order to be more informed medical consumers. Provides Choice: Members are presented with cost-effective options in their geographic area that qualify for financial rewards based on Compass procedure rankings. Rewards Cost-Effective Decisions: Members are rewarded with financial incentives by choosing to have their elective procedures performed at Compass-identified cost-effective locations. 13

Compass Healthcare What do you need to know in order to use SmartShopper ? Everyone covered on your health plan is eligible to use SmartShopper. Shopping takes only minutes—a two minute phone call, or a few mouse clicks gives you the cost-effective information you need. To earn an incentive, shopping must occur AT LEAST 24 HOURS prior to the scheduled procedure. Use a cost effective location and your reward will be mailed to you automatically within 45 days from the time your claim is processed. 14

Dental Plan: Delta Dental Benefit Deductible (Major / Restorative only)$25 Per Person Annual Maximum Benefit$1,500 Per Person Preventive Services100% Basic Services80% Major / Restorative (deductible applies)50% Orthodontics50% Orthodontics Lifetime Maximum$1,500

Dental Plan: Delta Dental Don’t Forget to Stretch your annual maximum dollars! Seeing a PPO provider can save you money If your dentist does not participate in the PPO Network, you still have the safety of the Premier Network The PPO Network is new, only 24% of dentists in NH participate today, but it is growing... If your dentist participates in the Delta Dental PPO Network, then your annual maximum will go further. 16

Dental Plan: Delta Dental CUSTOMER SERVICE: o o 17

Vision Plan: DeltaVision ® Services Every 12 MonthsNetwork Non-Network (Reimbursement) Annual Vision Exam$10 Copay$35 Frames$130 Allowance$65 Standard Plastic Lens$25 CopaySingle: $25 copay Bi-focal: $40 copay Tri-focal: $55 copay Contact Lens (in place of frame lenses) $130 AllowanceConventional: $104 Disposable: $ % Employee Paid

Vision Plan: DeltaVision ® NETWORK: EyeMed “ACCESS NETWORK” o Local Provider o Lens Crafters o Sears Optical o Pearle Vision o Target Optical o J.C. Penney Optical o If your provider is not in-network, they can be at their request 19

Vision Plan: DeltaVision ® CUSTOMER SERVICE: o o Monday to Saturday, 7:30 AM to 11:00 PM, EST o Sunday, 11:00 AM to 8:00 PM, EST CLAIMS: o Network: Show your ID Card to the provider and they take care of the rest o Non-Network: Pay in advance for the service and submit a claim form for reimbursement NEAREST PROVIDER to White Mountains Community College o Tremaine Opticians, 148 Main Street, Berlin, NH ( ) 20

Life Insurance: The Standard LIFE INSURANCE: 100% Paid by CCSNH o ONE Times Annual earnings o Minimum Benefit of $25,000 o Maximum Benefit of $200,000 o Equal amount of Accidental Death Benefits o Eligibility: 37.5 Hours 21

VOLUNTARY Life Insurance: The Standard VOLUNTARY LIFE INSURANCE and AD&D: 100% Employee Paid o Prior Eligible Applicants: Subject to Underwriting o Employee: o Units of $25,000 o Maximum of $100,000 o Minimum of $25,000 o Spouse: o Maximum: Lesser of $100,000 or 100% of Employee Election o Plan 1: Units of $10,000 without AD&D o Plan 2: Units of $25,000 WITH AD&D o Children: o $3,000 Benefit 22

Long Term Disability: The Standard Long Term Disability: 100% Paid by CCSNH o Eligibility: 37.5 Hours Per Week o Benefit: o 60% of Earnings o Maximum Benefit of $6,000 per Month o Waiting Period: 180 days (6 months) o Benefit Period: to age 65 (if 62+, benefit period is adjusted) 23

Flexible Spending Account Employee Savings Monthly Account Fee: Paid by Employee o FSA Administration Fee: $3.50 per month o Dependent Care Administration Fee: $3.50 per month o Debit Card Fee: $0.65 per month Minimum Health Care Annual Contribution: $200 Minimum Health Care Annual Contribution: $2,500 Maximum Dependent Care Annual Contribution: $5,000 24

Questions?? 25 Tom Harte Landmark Benefits, Inc. 20 Mary E. Clark Drive, Ste. 10 Hampstead, New Hampshire P: