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Benefits ©2015 General Dynamics. All rights reserved.

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Presentation on theme: "Benefits ©2015 General Dynamics. All rights reserved."— Presentation transcript:

1 Benefits ©2015 General Dynamics. All rights reserved.

2 Agenda Medical Enrollment Resources Next Steps Enrollment Process

3 How PHAPs Work Maximum

4 Personal Health Account plans – Four medical options
Enhanced (PHA E) Non-Seeded Enhanced (PHA NSE) Standard (PHA S) Core (PHA C)

5 Meet Carla Brown 30 years of age Single Gets preventive care
Quite healthy No chronic health issues Occasional mild cold or flu

6 Carla’s 2016 Healthcare Two doctors visits Annual physical
Gets a “clean bill of health” Annual physical Severe cold Minor cut from bicycle fall. No stitches or tetanus shot required but needs antibiotic. Two doctors visits Prescription for an antibiotic Prescription

7 How Carla Would Fare in 2016 Service Provider charge HMO PHA Enhanced
Annual physical $225 $15 $0 2 office $180 $360 $30 1 $30 $10 Carla’s medical expenses $615 $55 $390 Company HSA Contribution $1,500 Annual Premium $2,388 $1,445 Total Healthcare Cost $2,443 $1,445 ($390 paid by Company HSA contribution) Savings $608 HSA Rollover Amount $1,110

8 Meet the Walkers Jack works for GDMS Jack and Betsy have two children:
Billy — age 14 Allison — age 12 Healthy. No major health issues Obtain preventive care each year 8

9 Walker Family’s 2016 Healthcare
Preventive care obtained for family Preventative care Taken to ER but checks out OK. Son Billy suffers head injury in baseball game Requires visit to doctor, lab tests, and prescription medication. Wife Betsy has sinus infection Taken to ER. Nothing fractured but she sees a specialist for follow-up. Daughter Allison has bike accident 9

10 How Walkers would fare in 2016...
Service Provider Charge HMO Enhanced PHAP Preventive Care $1,400 $60 $0 Office Visits $1,500 $15 Prescription $25 $10 2 ER Visits $100 (copay for both visits) $1, (reached deductible at $1,475 and remaining $25 was subject to 10% coinsurance) Walkers’ Medical Expenses $4,425 $85 $3,002.50 Company HSA Contribution $3,000 Annual Premium $6,256 $4,476 Total Employee Healthcare Cost $6,341 $4,478.50 Savings $1,862.50 HSA Rollover $0 (without employee contributing to HSA) With the Personal Health Account Plans, the deductible and coinsurance would once again apply to covered services such as those listed. If you add up all the non-preventive care costs for the family (all the expenses in the top blue area), that group of costs totals $5,330 for the year. Under the Standard PHA Plan, the first $2,500 of those expenses applies to the deductible, leaving the remaining $1,430 in expenses to be paid through coinsurance. So the plan would pay 80% of those remaining charges, leaving 20% or $286 to be paid by the family. Added to the $2,500 in costs applied to the deductible, the total out-of-pocket expense for covered services looks to be $2,786. Same procedure for the Enhanced PHA Plan, though here the deductible is $3,000 and the coinsurance is only 10%. Using that formula, expenses would be $3,093 as compared with $2,786 for the Standard PHA Plan. In this case, all three plans would end up costing somewhat comparable amounts. But remember that the HSA with the PHAPs can pay some of the OOP expenses with tax-free dollars and lower taxes for the household and possibly allow for some money to be saved for use in future years, even retirement. 10

11 Enrollment Process ©2015 General Dynamics. All rights reserved.

12 Enrollment Information
You are eligible for benefits beginning on your first day of employment Employees may enroll as soon as their 3rd day with GDMS by visiting New users will click on Register Now to establish an account. If you already have a Fidelity account, enter your username/password.

13 What happens if you don’t enroll within 31 days
Benefit Medical Employee only Non-Seeded Enhanced PHA coverage with no contribution to the HSA Dental No coverage Vision Flexible Spending Accounts No contributions Life and AD&D GDMS-provided benefit only; no supplemental coverage Disability 401(k) 3% of eligible pay deducted on a pre-tax basis and invested in the target date fund

14 Resources ©2015 General Dynamics. All rights reserved.

15 The Benefits Counselor is In!
ALEX® is your personal online benefits counselor He’s amusing, offers straight talk -- not insurance-talk -- and is available to help you figure out which benefit plans will best serve your needs ALEX® will ask some basic questions about your personal situation, crunch some numbers, and explain your available benefits options Visit ALEX® today at: Enroll at:

16 GDMS Benefits Website www.gdmsbenefits.com Summary Benefits Charts
2016 GDMS Benefits booklet 2016 Calendar Voluntary Insurance Discount Plan and Services Adoption Assistance Legal Services Plan Pet Insurance Insurance Contact Information Annual Enrollment

17 GDMS Benefits Team benefits@gd-ms.com
Benefits Resources GDMS Benefits Team Question and Answer session every Wednesday at 1PM ET Participant Passcode GDMS Benefits website Alex, the online benefits counselor General Dynamics Service Center ©2015 General Dynamics. All rights reserved.

18 Next Steps ©2015 General Dynamics. All rights reserved.

19 Dependent Verification
Dependents of employees enrolled in health insurance plans (medical, dental, or vision) must be certified as eligible for coverage Letter explaining process along with directions and required forms sent to employees soon after enrolling dependents through Benefits Service Center GD recommends submitting documents through HMS website ( – letter will contain reference number needed to login Employees have 60 calendar days to complete the verification process at which time temporary coverage provided to dependents will become permanent. If employees do not submit documents within the 60-day timeframe, dependents will be dropped from all plans back to the effective date of coverage.

20 ©2015 General Dynamics. All rights reserved.

21 Embedded Medical Deductibles and Out of Pocket Maximums when covering a dependent
PHA Standard (PHA S) and PHA Core (PHA C) Plans Insured #1 Individual Deductible Amount Coinsurance PHA S Only Individual Out of pocket maximum Remainder of Family Deductible Insured #2 Insured #3 Reminder of family out of pocket maximum

22 Aggregate Medical Deductibles and Out of Pocket Maximums when covering a dependent
PHA Enhanced (PHA E) and PHA Non-Seeded Enhanced (PHA NSE) Plans Deductible Employee Spouse Child(ren)

23 Other Benefits to elect
HSA Contribution Spousal Surcharge Attestation FSA Beneficiaries Dental Vision Supplemental Life, AD&D PPTO 401k Hlth Insurance Agenda

24 Plan Designs for 2016 – Employee Only
Enhanced/Non-Seeded Personal Health Account Plans Standard Personal Health Account Plan Core Personal In-Network Out-of-Network Annual HSA Deposit* $600 (Enhanced) $0 (Non-Seeded Enhanced) N/A % You Pay for Preventive Care 0% 30% 40% Your Annual Deductible $1,500 $3,000 $2,600 $5,200 $6,350 $12,700 Coinsurance—the % You Pay After the Deductible 10% 50% Your Annual Out-of-Pocket Max $2,300 $4,600 $4,000 $8,000 What You Pay for an Office Visit, Inpatient, Outpatient, Imaging, Lab Services, etc. 10% after deductible 30% after deductible 50% after deductible No charge after deductible No charge after deductible What You Pay for Prescriptions : Generic Formulary Brand Non Formulary Brand Mail Order (additional discounts applied) 10% after deductible (Preferred Retail Network and PRIME mail) 30% (Prime Therapeutics Network) Not Covered 20% after deductible (Preferred Retail Network and PRIME mail); 40% (Prime Therapeutics Network) *HSA Deposit is prorated based on date of enrollment

25 Plan Designs for 2016 – Employee+Spouse, Employee+Child(ren) and Employee+ Family
Enhanced Personal Health Account Plan Standard Personal Core Personal In-Network Out-of-Network Annual HSA Deposit* $1,200 (Enhanced) $0 (Non –Seeded Enhanced) N/A % You Pay for Preventive Care 0% 30% 40% Your Annual Deductible Deductible Type $3,000 Aggregate $6,000 $5,200 Embedded $10,400 $12,700 $25,400 Coinsurance—the % You Pay After the Deductible 10% 50% Your Annual Out-of-Pocket Max Out-of-Pocket Max Type $4,600 $9,200 $8,000 $16,000 What You Pay for an Office Visit, Inpatient, Outpatient, Imaging, Lab Services, etc. 10% after deductible 30% after deductible 50% after deductible No charge after deductible No charge after deductible What You Pay for Prescriptions : Generic Formulary Brand Non formulary Brand Mail Order (Additional discounts applied) 10% after deductible (GD Preferred Retail Network or Kaiser Pharmacy) 30% (Prime Therapeutics Network) Not Covered 20% after deductible (GD Preferred Retail Network); 40% (Prime Therapeutics Network); 30% for Kaiser Pharmacy *HSA Deposit is prorated based on date of enrollment

26 Prescription Drug Coverage
PRIME Therapeutics - Prescription drug vendor for Corporate PHAPs (CIGNA, UHC, or BCBS) Two-tiered pharmacy network GD Preferred Retailers – Walgreens, Walmart, Kmart, Kroger, Target and Community Pharmacy Network PRIME Therapeutics Network – If you use a GD Preferred Pharmacy, you pay a lower coinsurance percentage after meeting the deductible. If you use a PRIME pharmacy, prescription benefits are available but there is a higher coinsurance percentage once you meet the deductible. Many maintenance medications for asthma, high blood pressure, diabetes and high cholesterol are employer paid GD medical plans do not offer out of network pharmacy coverage


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