Richmond Community Schools Open Enrollment November 10, 2015

What is driving the cost?  Claims Experience  Medical Inflation and Trend Average increase is 8-10% per year.  Technology Advances  New Expensive Drugs  ACA Requirements  New Taxes – PCORI, TRF

Affordable Care Act O Requirements  Waiting period limitation  Preventative care services paid at 100%  Minimum Value  Affordability  Expanded Appeals process  No pre-existing condition limitation  Dependent child to age 26 We are experiencing cost increase!

Cadillac Tax O Cadillac Tax (part of Affordable Care Act) Effective in 2018 Single cost maximum $10,200 Family cost maximum $27,500 Employer will pay 40% tax on cost over the threshold!

Eligibility  Working Spouse Rule – if spouse is eligible for other employer coverage, spouse must take it and then could be secondary under this plan.  Spouse must live in same household effective 11/1/15  Adult Children covered until age 26, regardless of other available coverage

Plan Design/Changes O Offer 2 plan options #1 – Traditional Deductible $1,000/$2,000 Ded. #2 – High Deductible $3,000/$6,000 Ded. with and HSA option NOTE: New Regulation – Individual deductible is embedded.

Plan Design/Changes O Rx Copay 30 day90 day O Generic: $4 $6  Brand Preferred:< 20% or $20< 20% or $20  Brand Non-Preferred:< 30% or $30< 30% or $30  At CVS and Walgreen: O Generic: $8 $12  Brand Preferred:< 30% or $40< 30% or $80  Brand Non-Preferred:< 50% or $60 < 50% or $120

Plan Design/Changes  Additional Rx Changes:  Specialty Rx limited to 30 days  Value Specialty: 10%, $150 max  Preferred Specialty: 30%, $250 max  Non-Pref. Specialty: 50%, $400 max  Implement Referenced Based Pricing

Employee Contributions O Use 4 tier rates (Employee, Employee+Child(ren), Employee+Spouse and Family) Helps to lower premiums for EE+CH and EE+SP tiers. Helps Cadillac Tax calculation Traditional plan – higher premiums High deductible plan – lower premiums

Employee Contributions Traditional HDHP EE$70.59$42.16 EE+CH$160.90$65.68 EE+SP$168.45$73.63 Family$173.45$ Based on 24 pays

Employee Contributions Dental Vision EE$1.68$1.50 EE+CH$15.88$1.50 EE+SP$13.41$1.50 Family$31.49$1.50 Based on 24 pays

Flexible Benefits  Annual Maximum for FSA: $2,550  Annual Maximum for Dep Care: $5,000  Use it or Lose it  Carry over of $500  May be used to pay for qualified Out of Pocket expenses  Optional Debit Card

Health Savings Account  Annual Contribution Maximum: Single: $3,350 Family: $6,750 Catch up contribution $1,000 for age 55 and older  Must be covered by a qualified HDHP  Distributions for qualified medical expenses are tax free.  Earnings are tax free  Distributions for other expenses subject to IRS tax and 20% penalty. (If over 65, penalty waived)

New Tax Form  Look for the new 1095 tax form in January!  Attach your W-2 and 1095 forms to your tax returns  1095 form documents your insurance coverage for 2015

Open Enrollment O Open Enrollment  Starts today – November 10  Link will be on RCS website  Deadline – December 4

(800) M:Renewal/2015/RichmondSchools/RCS Presentation pptx