1. 2018 Open Enrollment Meetings
Presented By:
Greg Biese Terry Adams
Associated Benefits & Risk Consulting UMR
VP, Senior Benefits Consultant Strategic Account Executive
Bobbi Verbeten, HIA Jenny Wydeven
Associated Benefits & Risk Consulting Delta Dental of Wisconsin
Account Executive Account Manager
Jennifer Nienow, CPhT
Optum Rx
Strategic Account Executive, Client Management

2. Meeting Agenda Medical Renewal HSA Refresher Flexible Spending
UMR Resources
Optum Rx Resources
Dental Renewal and Delta Dental Resources
Action Items
1095 / 1094 Reporting
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

3. 2018 Medical Eligibility & Rates
Spousal Surcharge will increase from $900 to $1,200 annually, effective
St. Norbert College reserves the right to change the eligibility requirements at any time.
St. Norbert College’s medical plan requires that an employee’s spouse enroll in at least single medical coverage through his/her employer to serve as their primary insurance coverage or pay an additional surcharge to enroll or maintain enrollment in St. Norbert College’s medical plan as primary coverage. This additional surcharge is $50.00 twice a month ($1,200 annually)
Spouse Medical Insurance Coverage Statements previously completed will carry-over into 2018 unless you notify Human Resources of any changes to your spouses’ status as of January 1, 2018.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

4. 2018 Benefit highlights
IMPORTANT HSA PLAN NOTICE (In-Network): No individual family member's deductible is considered satisfied until the full family deductible has been met. However, no individual family member can exceed $6,550 in out-of-pocket expenses per year. The out-of-pocket limit for all family members combined remains at $8,000.
(2) IMPORTANT HSA PLAN NOTICE (Out-of-Network): No individual family member's deductible or out-of-pocket is considered satisfied until the full family deductible and out-of-pocket has been met.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

5. 2018 Benefit highlights (cont.)
What are examples of preventive drugs: Medications used for diabetes, heart disease, cholesterol, blood pressure, blood thinner, and beta blockers.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

6. HEALTH SAVINGS ACCOUNT High Deductible Health Plan (HDHP) HSA Plan
PLAN TO SAVE
HEALTH SAVINGS ACCOUNT
PPO Plan
Lower deductible, higher monthly premiums
High Deductible Health Plan (HDHP) HSA Plan
High deductible, lower monthly premiums

7. HSA Overview
The Health Savings Account was created by Medicare legislation signed into Federal law in late 2003.
A marriage between an IRA account and the interest-bearing bank account.
Tax-sheltered Savings
Transaction Account
Earmarked for Medical Expenses
Immediate Medical Expenses
Future Medical Expenses
Retirement Expenses, including Medicare

8. Advantages of an HSA Ownership - you own the funds in your HSA
Tax-free
Portable
No “use it or lose it”
You may change your employee contribution amount throughout the year.
You can choose to invest your savings in an investment account.
One of the most significant advantages of owning a HSA is any contributions made to the account and funds accumulated are owned by the individual (not the employer). With that, the individual decides:
Whether he or she should contribute
How much to use for medical expenses
Which medical expenses to pay from the account
Whether to pay for medical expenses from the account or save the account for future us
Contributions are not subject to withholding for federal income tax. However, as previously mentioned, taxation varies by state. Account distributions are tax free when used for qualified medical expenses.
The HSA is portable. This means you take the account with you. For example, if an employee leaves and goes to another employer that offers a High Deductible Health Plan, they can have their employer start contributing to their account. When the employee is not covered by a HDHP but still has a HSA, they can use the funds for medical expenses.
Unlike Health Care Flexible Spending Accounts, there are no use it or lose it rules. This feature allows the account holder to rollover the account balance year after year.
The HSA is interest bearing both within the account and via the long term investment options.
Finally, as you look across the plan options offered by your employer, you will notice the High Deductible Health Plan has the lowest premium. While this is an advantage, you will want to make sure you understand how the plan works, because if you need to use Health Care you will have a higher deductible to satisfy before any benefits are paid by the plan.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

9. HSA – 2018 ELIGIBILITY Any individual that –
Is covered by a qualified High Deductible Health Plan (HDHP)
Is not covered by other health insurance
Is not enrolled in Medicare
Cannot be claimed as a dependent on someone else’s tax return

10. HSA – 2018 Annual Contributions
Annual contributions to the HSA are limited to $3,450 Single / $6,900 Family (Employer & Employee contributions combined)
St. Norbert College - Annual HSA Contribution:
$500 - Single coverage; $750 - Family coverage
Employer contributions will be deposited twice per year
Single: $333 (1st payroll in January); $167 (1st payroll in September)
Family: $500 (1st payroll in January); $250 (1st payroll in September)
Account holders age 55 and up may make additional contributions of $1,000
1/12th Rule may apply for mid-year plan enrollees
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

11. HSA Withdrawals / Distributions
Federal tax treatment of funds used:
HSA Withdrawals are always Federal tax free for qualified medical expenses, and are so at any age. After age 65, you can use the funds for non-qualified medical expenses without a penalty, but you the money will be taxed.
If you use your HSA funds for non-qualified medical expenses before age 65, not only will the funds be taxed, but you will also pay a 10% penalty.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

12. Eligible Medical Expenses for Tax-Free Distributions
Qualifying medical expenses - IRS Publication 502
Dental and vision care expenses
Long-term care insurance
Premiums for coverage while receiving unemployment compensation
A list of eligible expenses is provided on the website: HSA.AssociatedBank.com or by visiting IRS.Gov/IRS-df/p502.pdf
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

13. Processing claims
Don’t pay your doctor immediately after your office visit.
Your insurance carrier will review your health insurance plan, and apply applicable discounts to your bill.
After the insurance company has reviewed your bill and health plan, you will receive an updated billing statement showing the true cost due.
All discounts have been applied, now is the time to pay your bill – Explanation of Benefits (EOB)
Pay for your prescriptions at purchase 12

14. Bank Information
At the end of the year, the bank will send each account beneficiary a statement with the fair market value of the HSA and forms with the total contributions and distributions:
Form 1099-SA (distributions)
Form 5498-SA (contributions, rollover deposits and fair market value for each calendar year)
This information is reported to the IRS.
You will need to complete form 8889 and file with your personal income tax return.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

15. Health Savings Accounts (HSA) and Flex Spending Accounts (FSA)
One of the qualifications to have an HSA is that you are not covered by any other low deductible insurance – this includes an FSA.
Therefore, if you enroll in the HDHP plan and open an HSA account, you may not participate in a standard FSA plan. However, you may enroll in a Limited FSA which can be used to reimburse dental & vision expenses ONLY.
You may still participate in the dependent care account.
One of the most significant advantages of owning a HSA is any contributions made to the account and funds accumulated are owned by the individual (not the employer). With that, the individual decides:
Whether he or she should contribute
How much to use for medical expenses
Which medical expenses to pay from the account
Whether to pay for medical expenses from the account or save the account for future us
Contributions are not subject to withholding for federal income tax. However, as previously mentioned, taxation varies by state. Account distributions are tax free when used for qualified medical expenses.
The HSA is portable. This means you take the account with you. For example, if an employee leaves and goes to another employer that offers a High Deductible Health Plan, they can have their employer start contributing to their account. When the employee is not covered by a HDHP but still has a HSA, they can use the funds for medical expenses.
Unlike Health Care Flexible Spending Accounts, there are no use it or lose it rules. This feature allows the account holder to rollover the account balance year after year.
The HSA is interest bearing both within the account and via the long term investment options.
Finally, as you look across the plan options offered by your employer, you will notice the High Deductible Health Plan has the lowest premium. While this is an advantage, you will want to make sure you understand how the plan works, because if you need to use Health Care you will have a higher deductible to satisfy before any benefits are paid by the plan.
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

16. FLEXIBLE SPENDING ACCOUNT (FSA)
Healthcare FSA
Annual limit of $2,650 (capped per IRS regulations)
Pre-tax dollars used to pay for qualified medical, dental & vision expenses
Limited flex (reimbursement for dental & vision expenses only) for those enrolled in the HDHP Plan (HSA)
$500 roll-over feature. Allows healthcare FSA participants to roll-over up to $500 of their previous year’s funds and add them to the new year plan. Rollover funds can only be used after the dollars from the new year’s plan have been used up. (Unused FSA funds in 2018 will roll-over into 2019)
Dependent Care FSA
Annual limit of $5,000 (pre-tax dollars used to pay for daycare expenses)
My Mobile Account Assistant (For Android and iPhones)
Camera scans documentation
Upload with claim information
Receive notification when a claim is processed
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

17. Better information, better decisions, better health on UMR.com
In two clicks
UMR.com gives members access to:
Health cost estimator tools MyHCE (My Healthcare Cost Estimator)
Provider search capability to identify quality and cost efficient providers classified by
Health education library
Resources on healthy living
Access to OptumRx
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

18. Like anything else, it pays to shop around
Your costs may depend on what doctor you see and where you go for care. Use myHealthcare Cost Estimator (myHCE) to:
Search for treatments/procedures from local providers
View estimates, including your out-of-pocket costs and what your plan will pay
Choose a provider and get a final estimate
Look for
Why did my co-worker pay less for the same treatment I received?
© 2013 United HealthCare Services, Inc.

19. Learn more about health topics that matter to you
Use Health Education Library to:
Access thousands of articles, illustrations and photos
View 120 videos on health topics
Research medical conditions, symptoms, treatment options, surgeries and medications
Check symptoms and drug interactions
© 2013 United HealthCare Services, Inc.

20. SECURE Mobile Web Access (No Download Necessary)
Simplified navigation
What’s new
Find out about new tools and information to help you live a healthier life.
Need help?
Click the question mark any time you are confused about a term or benefit and get an explanation.
Home: Return to the main menu. Menu: Display the menu.
Gear: Log out or learn more.
Log in
Enter your username and password for instant access to all our mobile inquiry tools.
Look up claims
Look up a claim for yourself or an authorized dependent.
Check your benefits
View medical and/or
dental benefits, as well as
persons covered.
Find a provider
Need to find a doctor fast? Access an alphabetical listing of network providers.
View, scan or fax your ID card
View your ID card, allow your provider to scan the on-screen bar code for instant access to your benefit information, and/or fax it to a provider. .
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

21. ID Card Details
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

23. PPO Plan vs. HDHP/HSA Plan (OptumRx)
HDHP Plan (HSA)
Deductible
No Deductible on Rx
Includes Medical & Rx
$2,000 Single / $4,000 Family
Out-of-Pocket Maximum
$2,250 Single / $4,500 EE+1
$6,750 Family
$4,000 Single / $8,000 Family
Retail Copays / Coinsurance
Tier 1: $10 Copay
Tier 2: 25% Copay ($100 Maximum)
Tier 3: 35% Copay ($150 Maximum)
Rx Copays / Maximums will double for Maintenance Medications if you continue to use retail after 2 consecutive fills.
Deductible, 90% Coinsurance
Mail Order Copays / Coinsurance
Tier 1: $30 Copay
Tier 2: $90 Copay
Tier 3: $180 Copay
Generic Preventive HSA Medication *
N/A
100% Coverage if Filled at Mail Order
* What are examples of preventive drugs: medications used for diabetes, heart disease, cholesterol, blood pressure, blood thinner and beta blockers.

24. Make your Health a Priority
Easy access to flu shots and other vaccines. Many vaccines can be obtained on a walk-in basis at your local pharmacies.
$0 copay at network pharmacy
Local Retail Pharmacies: Target, CVS, Shopko, Walgreens. For full list log in to optumrx.com

25. Optum Rx digital member tools
Online Portal
Convenient user-friendly tools help simplify and improve the member experience
The OptumRx App
Easy-to-use pharmacy features make the consumer experience simpler, faster and easier
Review pharmacy benefit highlights, coverage, prescription drug list, order status, claims history
Enroll or access Home Delivery Pharmacy prescriptions; price prescriptions
Refill, fill new, renew, transfer from retail to home delivery, and switch to a lower cost option
Manage household or caregiver access
Locate a retail pharmacy
Refill select specialty pharmacy medications
Access health tools / medication reminder enrollment
View search tools on all pages
Quickly check-out prescriptions
Access ID card/Update multiple credit cards for payment
Manage household
Price drugs for home delivery and multiple retail locations
View personalized lower cost messaging
Easily transfer a retail script to home delivery
Set up and receive text message reminders
Easily track orders
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.

26. OptumRx Member Portal Reshaping the Experience Quick Links
High-level quick links put members in control of available programs such as:
drug search and pricing
virtual medicine cabinet
home delivery
automatic refills
Simple Explanations
Videos available to educate members about the site
Reshaping the Experience

27. Member Portal: Overview
The OptumRx portal empowers members to become informed advocates of their own health
My Medicine Cabinet: Displays at-a-glance actions a member needs to take for all their medications
Drug Pricing: Members can compare drug costs between up to 5 pharmacies and view lower cost alternatives
Proactive Savings Messaging: Advocates for the member by providing proactive ways to save
Order Status: Members are able to track where their order is within the process and remove various order holds without having to call customer service
Member Tools: Provides easy access to the most commonly used member tools throughout the site
Household Access: Ability to manage prescriptions on behalf of your family members

28. Mobile app overview Home page Streamlined user experience
Easy access to actions they may need to take
Access to most commonly used member tools
Ability for members to view all of their medications
Coming soon:
New prescription via photo
Pill identifier
Apple Watch
View Specialty and OTC
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum.

29. Your Dental Benefits

31. member connection Benefits and Claims information ID Card(s)
EOB Summary
Provider Search
Access to oral health resources and information

32. dELTA DENTAL MOBILE APP
Find a Dentist
View your claims & coverage
View your ID card
Toothbrush timer
Cost Estimator
May select from a list of treatment categories
Broken down by individual procedures (where applicable) and includes a total for entire treatment
Estimates reflect actual fees charged by dentists
Identifies in-network dentists

33. COMPREHENSIVE DENTAL BENEFITS
Benefit Plan Design
Delta Dental PPO, Delta Dental Premier &
Non-Contracted Dentist
Individual Annual Maximum
$1,000
Annual Deductible
$50 per Individual; $150 Maximum per Family
Fee Schedule
Maximum Plan Allowance (MPA)
No Balance Billing for Network Providers
Diagnostic & Preventive Services: Exams, Cleanings, X-Rays, Fluoride Treatments and Sealants
100% of MPA
Basic & Major Services: Fillings, Surgical & Non-Surgical Extractions, Endodontics and Periodontics
80% of MPA
(Deductible Applies)
Major Restorative Services: Crowns, Inlays, Onlays, Implants, Bridges and Dentures
50% of MPA
Orthodontic Lifetime Maximum
(Dependents to age 19)
50% of MPA up to $1,000

34. Benefit Changes for 2018
Resin-Based Composite (White Filling) Enhancement: Full Mouth Coverage (Currently limited to front teeth only).
Allows your dentist to choose which restorative material best fits your dental needs.
Reduced X-Ray Frequency: Full-Mouth X-Rays limited to once every 5 Years (Currently covered once every 3 Years)
Recommended by the American Dental Association
Evidence-Based Integrated Dental Care: Provides extra cleanings (up to 4 annually) and fluoride treatments for individuals with certain medical conditions.
Continued on next page

35. EVIDENCE BASED INTEGRATED CARE PLAN (ebicp) – New Benefit 1.1.2018
EBICP provides additional preventive benefits for those who need them most.
No additional claim forms are needed.
Delta Dental is proud to provide a plan enhancement for those of you who may benefit from additional cleanings. Called Evidence-Based Integrated Care Plan (EBICP, for short), it offers additional cleanings (and fluoride, when applicable) for conditions such as periodontal disease, diabetes, and cancer-related treatments.

36. Dental plan changes for 2019
Eliminating the Maximum Benefit Bonus (MBB) Program.
A portion of your unused annual maximum may be placed in to your MBB account for use in future years.
Adding CheckUp Plus
Diagnostic and Preventive services do not apply towards the annual maximum.

37. Required Forms to Be Completed
Deadline for enrollment forms is November 22, Return completed forms to your Human Resources Department.
UMR enrollment form: (new enrollees, adding/removing dependents, dropping coverage, plan election changes)
Not required if you are keeping your current coverage
Spouse medical insurance coverage statement
Required if your spouse has any change in medical coverage available to them through his/her employer’s plan.
Associated Bank Health Savings Account (for those enrolling in the HDHP/HSA Plan)
Complete application and applicable forms to open your HSA bank account and start contributing!
Delta Dental enrollment form (new enrollees, adding/removing dependents only, dropping coverage)
EBC - FSA enrollment form (No more Paper Forms, enrollment on EBC website)
Enrollment does not carry over - employees who wish to participate must enroll again for 2018
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

38. Irs employer reporting
Proof of Earnings
W-2
January 31st
Proof of Health Insurance
1095
January 31st
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

39. Form 1095-C
You and/or your family members will likely be receiving some new tax forms in January. Some of the these forms will be necessary for you to complete your tax filing to prove you and your family had health coverage and avoid having to pay the individual mandate penalty that is part of healthcare reform.
You can expect to receive the following form in connection with your employment with St. Norbert College
Every ‘benefit eligible’ employee will be receiving a 1095-C from St. Norbert College no later than January 31, You will receive this form in one of two circumstances :
You or a family member were a “full-time employee” (as defined by the ACA) at any time during the year
You or a family member obtained your health insurance coverage from a large employer through a self-funded health plan (ie: St. Norbert College)
Depending on your circumstances you and your family may receive multiple 1095s from different reporting entities.
This form is necessary for you to complete the tax filing process to prove you and your dependents had health coverage in order to avoid having to pay the individual mandate penalty
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx

40. Questions?
St. Norbert College/18/Ren/2018 OE Meetings Presentation.pptx