2014 Employee Benefits Review & Open Enrollment William Jewell College October 28 th, 2013.

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Presentation transcript:

2014 Employee Benefits Review & Open Enrollment William Jewell College October 28 th, 2013

Today’s Agenda Discussion Topics Open Enrollment – October 28 th through November 15th Healthcare Reform Benefit Review Medical: Blue Cross Blue Shield of Kansas City Dental: Blue Cross Blue Shield of Kansas City FSA: Phillips Resource Network Life and Long-Term Disability: Lincoln Financial Group Voluntary Vision: EyeMed Voluntary Short-Term Disability: Aflac Good News! There are NO benefit changes for 2014!!!

Open Enrollment This is the time to make benefit decisions. Changes outside of Open Enrollment are only allowed if you have a Qualifying Event: Marital Status Loss of Coverage Birth of a Child Adoption Death Pre-tax Premium laws require you make your elections for the Plan year with no changes unless you have a Qualifying Event. Please notify the HR Department within 30 days of a qualifying event to make a change.

Health Care Reform – What does it mean for me? Beginning in January 2014, the Affordable Care Act (ACA) requires most individuals to obtain “minimum essential” health insurance coverage for themselves and their family members or pay a penalty, unless you qualify for an exemption. This is your opportunity to enroll in William Jewell College’s health plan to meet that requirement. Both of the health plans offered by Jewell meet the “minimum essential” coverage requirements for Therefore, employees (and their dependents) eligible for coverage through Jewell would not qualify for subsidies through the Marketplace (Exchange). The next opportunity you have to enroll in these benefits will not be until Open Enrollment next year which will take place in October of You may have an opportunity to enroll outside of the Open Enrollment period if you have a qualifying life event. Get more information on the Health Care Reform by going to

William Jewell College Insurance Withholdings for 2014 HMO COST SHARING TABLE BY ANNUALIZED SALARY Under $30,000 At least $30,000 & under $47,000 At least $47,000 & under $61,500 At least $61,500 & over 1/2-3/4 Time Employees Employee Only $44.00$46.20$57.00$59.85$69.00$72.45$81.00$85.05$195.90$ Employee + 1 $138.00$144.90$207.00$217.35$260.00$273.00$346.00$363.30$379.05$ Family $159.00$166.95$224.00$235.20$293.00$307.65$361.00$379.05$538.75$ PCB COST SHARING TABLE BY ANNUALIZED SALARY Under $30,000 At least $30,000 & under $47,000 At least $47,000 & under $61,500 At least $61,500 & over 1/2-3/4 Time Employees Employee Only $41.00$43.05$53.00$55.65$64.00$67.20$75.00$78.75$181.65$ Employee + 1 $132.00$138.60$197.00$206.85$250.00$262.50$341.00$358.05$359.13$ Family $152.00$159.60$215.00$225.75$285.00$299.25$353.00$370.65$510.44$535.96

2014 Benefit Plans Blue-Care HMO Preferred-Care Blue PPO

EMPLOYEE BENEFITS 2014 Your 2014 Medical Plan Options Blue-Care – HMO (Health Maintenance Organization) Select a Primary Care Physician (PCP); in-network only; metro Kansas City area coverage only Preferred-Care Blue – PPO (Preferred Provider Organization) No selection of PCP; In and Out of Network; National and International Coverage

EMPLOYEE BENEFITS Office Visits PCP: $30 (IM, GP, FP, PED) Specialists: $60 (ENT, Derm, OB/GYN) Inpatient Hospital Services/Outpatient Surgery $250 copay per day / per occurrence up to $1,250 per calendar year (applies to inpatient services at a hospital and outpatient surgeries at a hospital or an outpatient facility) MRI, MRA, CT and PET Scans Physician’s Office, Imaging Center, Outpatient Setting $100 copay Only one copay will apply for each provider on a specified date of service even if multiple scans are performed Routine Vision Exam$10 copay Urgent Care (Minute Clinics, Take-Care Centers) $60 copay (office visit/lab only) Emergency Care$100 copay if treated and released (copay waived if admitted to hospital)

EMPLOYEE BENEFITS 2014 Preferred-Care BlueIn-NetworkOut-of-Network Office Visit$40 copay* Deductible then 40% Deductible: Individual$2,500 Deductible: Family$5,000 Coinsurance (your share):20% 40% Out-of-Pocket Maximum: Individual $4,500 $9,000 Out-of-Pocket Maximum: Family $9,000 $18,000 Hospital: Inpatient or Outpatient Deductible then 20% Deductible then 40% MRI, MRA, CT and PET Scans Physician’s Office, Imaging Center, Outpatient Setting, including hospital Deductible then 20% Deductible then 40% Emergency Room$100 copay then deductible then 20% Urgent Care (includes Minute Clinics and Take Care Centers) $40 copay* Deductible then 40% *Copay includes Office Charge & Lab services in Physician’s office or Independent Lab

EMPLOYEE BENEFITS 2014 Hospital Locator Hospital NameHMO Blue Care Network PPO - Preferred Care Blue Network Center Point Medical Center XX Children’s Mercy Hospitals XX KU Medical Center XX Lee’s Summit Hospital XX Liberty Hospital XX Menorah Medical Center XX North Kansas City Hospital XX St. Luke’s (All Locations) NOX Olathe Medical Center XX Overland Park Regional XX Providence Medical Center XX Research Medical Center XX Shawnee Mission Medical Center XX St. Joseph Medical Center XNO St. Mary’s Medical Center XNO Truman Medical Center (Hospital Hill and Lee’s Summit) XX

EMPLOYEE BENEFITS 2014 Preventive Care: What to Know! Your BCBSKC plans will cover Preventive Care Services at 100%, according to established government guidelines: Annual Physicals Childhood Immunizations Well Women Exams PSA Tests Services MUST be Preventive and received by In- network providers Effective: January 1, 2014 Generic Contraceptive drugs at 100% Contraceptive implants, injectables & devices at 100% Breastfeeding support, supplies (pumps) and counseling at 100%

EMPLOYEE BENEFITS 2014 Prescription Drug Coverage Retail and Mail-Order – Both Plans Certain drugs may require prior authorization, have quantity limitations or require step therapy (Generics First). Refer to for additional details. 34 day supply In-Network Pharmacy Tier 1: $10 Tier 2: $50 Tier 3: $ day supply Mail-Order Tier 1: $20 Tier 2: $100 Tier 3: $140

EMPLOYEE BENEFITS 2014 Urgent Care Receive care for non-life threatening conditions You are responsible for the $60 Urgent Care copay when using a Network Urgent Care Facility Use Take-Care Centers or Minute Clinics NOT the Emergency Room Outside of the BCBSKC service area? Contact your PCP prior to treatment Emergency Care Go to the nearest Emergency Room or call “911”. Receive treatment and pay the $100 ER copay if treated and released. The ER copay is waived if admitted to an HMO hospital for the same condition within 24 hours. YOU MUST contact your PCP within 48 hours (or as soon as reasonably possible) after you receive medical attention. Need To Know… HMO Blue-Care Plan Urgent Care and Emergency Care Please Login to for a complete list of Urgent Care Facilities in your area.

EMPLOYEE BENEFITS 2014 Worldwide Network of PPO Healthcare Providers Welcomed in over 200 countries Worldwide BlueCard PPO Network National Network Access through BlueCard ®  1,177,194 Physicians  6,776 Hospitals  Access in ALL 50 States

2014 Wellness Program Step 1*Complete the Onsite Health Screening (or alternate means screening form) for 25 Points Step 2*Take the Health Risk Assessment (HRA) for 25 Points *Steps 1 and 2 must be completed to be eligible to redeem My Rewards. Step 3Engage In Additional Activities for 25 Points You may earn additional points by participating in the following activities: Lifestyle Coaching (goals met): 10 pts; max 30 pts Health Advising Call: 10 pts Self-Directed Coaching Assessments: 5 pts; max 15 pts Tobacco Cessation Program: 20 pts Onsite Classes or Webinars: 5-20 pts Healthy Companion Condition Management (goals met): 10 pts; max 30 pts Little Stars Prenatal Assessment: 5 pts; max 10 pts My Rewards: Members and spouses on the plan can redeem up to a total of $75 when 75 points are achieved.

EMPLOYEE BENEFITS View Your Claims, Print a Temporary ID card & Find Added Value Info

24-Hour Nurse Line Access to Care Advisors to help you with symptoms or answer health-related questions How Can They Help? ◦ Gain convenient access to quality care ◦ Become better informed about healthcare ◦ Gain confidence when speaking to providers ◦ Become educated on self-care for non-urgent situations ◦ Improve knowledge of drugs and medications 24 hours a day…365 days a year!

EMPLOYEE BENEFITS 2014 Exclusively For Our Members A value-added program exclusively for Blue KC members.  Helping you live healthy means more than regular doctor visits  Blue365 ® is a national program that is part of your Blue KC membership  Provides exclusive access to information, discounts, and savings Blue365 can:  Add exclusive value-added extras to an already attractive and competitive benefit package  Be a strong health and wellness resource

EMPLOYEE BENEFITS 2014 Preferred-Care Dental BluePremier Network Type IType IIType IIIType IV DeductibleNone$50 / $150None Blue Cross Pays (Preferred-Care Dental and Out-Of-Area Providers) 100%80%50% Blue Cross Pays (Non-Preferred-Care Dental Providers within our Operating Area) 80%70%40%50% Covered Services Dental X-rays Routine Oral Exam Cleaning – two each calendar year Root Canal Tooth Extraction Bridge Recementing Complete or Partial Dentures Surgery of Gums Periodontal Scaling Orthodontia ( to age 19): Cephalometric X-rays. Diagnostic casts. Calendar Year Maximum $1,000 per person for all servicesN/A Lifetime MaximumNone$1,000 Preferred

EMPLOYEE BENEFITS 2014 Explore the website for added value discounts, Prescription drug costs, price health procedures Choose the Right Health Care Setting Generics vs. Brand Name Drugs. Visit the website bluekc.com to find an In-Network Provider Call Nurseline Annual Physicals Communicate with your Doctor Open a Flexible Spending Account Participate in a Wellness Program Consumer-Driven Tools

Flexible Spending Accounts Information + Enrollment = Savings

What is an FSA anyway? An FSA adds spendable income and covers many expenses. You may redirect part of your paycheck into a pretax account. 22 FSA Benefit Buckets Available: IRS Determines Limits 1- HEALTHCARE FSA: Medical, Dental, Vision, Pharmacy & approved OTC. $2,500 and/or 2- DEPENDENT CARE FSA: Daycare expenses. $5,000 You can participate in one or both types of FSA

23 How will it benefit me? Paycheck Advantages: - Increased take-home pay - Lower income taxes $$ Double benefit $$ Average family of four in the U.S. can save hundreds of dollars in taxes. …. Immediate availability of Healthcare account funds

24 Expenses covered? Medical & Dental Deductibles & co-pays Prescription drugs Vision (exams, glasses, laser eye surgery, contact lens solution) Diabetic supplies Hearing Aids Medical travel expenses Chiropractic services Dental (cleanings, fillings, orthodontia, dentures) And many more! *Over the counter….what qualifies…. Dependent Care Daycare (child under age 13) Private Nanny or Babysitter Adult Daycare

25 How to submit claims Option 2: Paper Claims. Fax or mail a claim form to Phillips Resource Network with an Explanation of Benefits (EOB) and/or receipt. Receipts must include a patient name, date of service, type of service and dollar amount PLAN YEAR: On January 1, 2014, your Benny Card will be loaded with your new plan year dollars. Please DO NOT use your card to go back and pay for any services in 2013 past the 75 days PLAN YEAR: 75 day extension on allowable expenses with an additional 30 days to submit claims from any monies remaining from the 2013 bucket. Services must be incurred while actively employed and will be applied to the applicable plan year. Option 1: The Benny Card. The card is used at the point of service at hospitals, doctor’s offices and pharmacies. The card cannot be used to purchase over-the counter medication without a prescription. Save all receipts as you may be asked to substantiate your expense. Keep your Benny Cards! NEW !! Grace Period is now available on Benny Card Swipes and Manual Claims for 75 days For the 2013 plan year, the last day to use your 2013 funds is March 16, 2014 For the 2014 plan year, the last day to use your 2014 funds is March 16, 2015

26 Things to remember… Choose plan election amounts carefully Use it or Lose it Rule Contribution amounts can only be changed during the plan year due to a qualifying event (i.e., marriage or birth of a child) Expenses are reimbursed through an FSA after they are incurred; pre- payments are reimbursed as services are received Participation at any level will increase your take home pay!

27 We’re here to help! PLEASE DIRECT QUESTIONS TO PHILLIPS RESOURCE NETWORK, INC. OUR PHONE NUMBER AND ADDRESS IS ON EVERY CLAIM FORM. REMEMBER BY ENROLLING IN THIS PLAN, THE MONEY YOU REDIRECT IS NOT SUBJECT TO FEDERAL, STATE, OR SOCIAL SECURITY TAXES! Every employee must complete a 2014 FLEX form even if waiving coverage or not making any changes

William Jewell College Employer Paid Benefits (All Full-Time Employees and All Regular Part-Time Employees and Adjunct Faculty who are enrolled in the Employer’s Group Health Plan) Basic Life Insurance 1 times annual salary for employees $50,000 minimum amount to $150,000 maximum Dependent Life Insurance $2,000 benefit for spouse $1,000 benefit for children from 14 days to 20 (26 if full time student) years of age Basic Accidental Death and Dismemberment $25,000 for employees Long Term Disability 60% of monthly salary to $5,000 maximum monthly benefit Payable after 120 days of disability Payable to later of age 65 or SSNRA

William Jewell College Voluntary (Employee Paid) Options (All Full-Time Employees and All Regular Part-Time Employees and Adjunct Faculty who are enrolled in the Employer’s Group Health Plan) Voluntary Life  Choice of $10,000 increments of coverage for yourself not to exceed the lesser of 5 times salary or $500,000 maximum benefit for employees.  Choice of $5,000 increments of coverage for your spouse not to exceed ½ of employee amount or $250,000.  Choice of $2,500 increments of coverage for children after 6 months of age to a maximum benefit of $10,000.  You or your spouse may elect or increase coverage by one or two increment levels on a guaranteed acceptance basis during your company’s defined annual open enrollment period, provided that you or your spouse have not been previously declined for coverage or withdrawn a previous application for coverage. Voluntary AD&D  Choice of $25,000 increments of coverage not to exceed 10 times salary or $500,000 maximum benefit for the employees on the Employee Only Plan or Family Plans  If elected, Spouse is provided 60% of employee amount when Children are not covered on the Family Plan.  If elected, Spouse is provided 50% of employee amount and Children are covered for 10% of the employee amount (not to exceed $15,000) when all are covered on the Family Plan.  If elected, Child is provided 15% of employee amount (not to exceed $15,000) if only Children are covered on the family plan.  There is an annual open enrollment for coverage on Voluntary AD&D.

EyeMed Exam & Materials Plan In Network Member’s Cost Out of Network Allowance Exam with dilation as necessary$10 copay$30 Frequency: Examination Lenses or Contact Lenses Frame Once every 12 months Once every 24 months Exam Options: Standard Contact Lens Fit and Follow-Up:* Premium Contact Lens Fit and Follow-Up:** Up to $40 10% off retail price N/A Frames: Any available frame at provider location $130 allowance, 20% off balance$65 Standard Plastic Lenses: Single Vision Bifocal Trifocal Standard Progressives $25 copay $90 $25 $40 $60 $40 Lens Options UV Coating Tint (Solid and Gradient) Standard Scratch-Resistance Standard Polycarbonate Standard Polycarbonate-Kids under 19 Standard Anti-Reflective Coating Other Add-Ons and Services $15 $40 $45 20% off retail N/A Contact Lenses (Materials Only) Conventional Disposable Medically Necessary $130 allowance, 15% off balance over $130 $130 allowance, plus balance over $130 $0 copay, paid-in-full $104 $200

EyeMed Materials Only Plan Materials Only PlanIn Network Member’s Cost Out of Network Allowance Frequency: Lenses or Contact Lenses Frame Once every 12 months Once every 24 months Frames: Any available frame at provider location &0 Copay ; $130 allowance, 20% off balance over $130$65 Standard Plastic Lenses: Single Vision Bifocal Trifocal Standard Progressives Premium Progressives Lenticulars $0 copay $65 $65,80%of charge less $120 allowance $0 copay $25 $40 $63 $40 $63 Lens Options UV Coating Tint (Solid and Gradient) Standard Scratch-Resistance Standard Polycarbonate Standard Polycarbonate-Kids under 19 Standard Anti-Reflective Coating Other Add-Ons and Services $15 $40 $45 20% off retail N/A Contact Lenses (Materials Only) Conventional Disposable Medically Necessary $0 Copay $130 allowance, 15% off balance over $130 $130 allowance, plus balance over $130 $0 copay, paid-in-full $104 $200

EyeMed – Providers One of the largest, and most diverse vision panels Includes thousands of private practice optometrists, ophthalmologists and opticians Composition of panel – 75% independent, 25% retail Includes the nation’s top optical retailers, including :

Online Management for Members Once registered online at the member will be able to: – Locate a provider – choose the “Select” network – View benefit details – Order replacement ID card – View claims

Voluntary Short-Term Disability Guaranteed-issue Short-Term Disability Guaranteed, renewable to age 70 Benefits paid regardless of any other insurance 3-Month Benefit for illness or off-the-job accident $500 to $3000 in monthly benefit guaranteed issue Waiting period defined by each individual’s needs Partial disability benefit Payroll deduction

Income Replacement Example Jewell employees are provided long-term disability that begins after 120 days for an illness or off-the-job accident. Aflac short-term disability can be purchased to provide income replacement for the first 90 days, reducing the income gap to only 30 days

Example: $34,000 Annual Salary Age: /14 – 14 calendar days waiting for an off-the-job accident – 14 calendar days waiting for an illness 3 Month Benefit period Qualify for $1,700 Monthly Benefit $28.73 monthly premium

Example: $50,000 Annual Salary Age: /14 – 14 calendar days waiting for an off-the-job accident – 14 calendar days waiting for an illness 3 Month Benefit period Qualify for $2,500 Monthly Benefit $42.25 monthly premium

Commerce Bank Special employee banking benefits No ATM fee when using the on-campus ATM located in Yates-Gill College Union

IMPORTANT Forms to turn in: 2014 FLEX form Any changes to other benefits* Open Enrollment: October 28th through November 15th ALL applications and changes must be turned in no later than November 15 th to the Office of Human Resources *Examples of changes include: Changing plan options Adding or Removing dependents Address or phone number changes Changing beneficiary designation If you have any additional questions please contact the Office of Human Resources.