Presentation on theme: "H.B. Fuller Company 2010 Open Enrollment: Helping you Buy Well, Use Well, Be Well October, 2009."— Presentation transcript:
H.B. Fuller Company 2010 Open Enrollment: Helping you Buy Well, Use Well, Be Well October, 2009
2 Overview of 2010 medical options Tools and resources How and when to enroll Incentives reminder and sales pitch Todays Discussion PURPOSE OF TODAYS MEETING: To help you understand your medical plan options
3 1 Medical Plan 3 Options for Paying Medical Plan
4 Market 500Value 750 High Deductible Plan Preventive care (in-network only) 100% Office visit copay $30 N/A Fuller HSA Contribution* N/A $500 Single $1,000 Family Prorated by pay period Emergency Room Co-pay $150 NA Medical Plan Options Summary
5 Why change ER Co-pays? Our ER usage is higher than the general population Cost of emergency room is $550-750/visit versus $110- 150 for regular office visit Most of our ER usage was considered preventable Emergency Room alternatives: Have a family doctor (Medical Home) Get regular preventive care Use Urgent Care or Walk In Clinics before the ER Aetnas DocFind has a link for alternatives to the ER
6 Market 500Value 750 High Deductible Plan In-network$500 Single $1,000 Family $750 Single $1,500 Family $2,000 Single $4,000 Family Out-of-network*$1,000 Single $2,000 Family $1,500 Single $3,000 Family $2,000 Single $4,000 Family Family Deductible* Imbedded single True family Medical Plan Options Summary Deductible – the amount you pay before the plan pays * This is an additional deductible – not part of in-network.
7 Deductible Example (Value 750) Single imbedded ($1,500 Family deductible) First family member pays single deductible - $750 then 20% going forward Remaining deductible$750 (other family members meet) True Family ($4,000 Family deductible) Cost for all family members $4,000 combined to meet deductible
8 Market 500Value 750HDHP w/ HSA Coinsurance – in-network 20% 0% Coinsurance – out-of-network 40% 0% Medical Plan Options Summary (cont.) Co-insurance: The percentage of the cost you pay after you meet your deductible
9 Market 500Value 750HDHP w/ HSA OOP maximum - in-network $1,500 Single $3,000 Family $3,000 Single $6,000 Family $2,000 Single $4,000 Family OOP maximum – out-of-network* $3,000 Single $6,000 Family $6,000 Single $12,000 Family $2,000 Single $4,000 Family Medical Plan Options Summary (cont.) Out of Pocket Maximum: The most you will pay out of pocket for the year Separate maximum for in-network and out-of-network. *OOP Maximum for out-of-network does not include costs over reasonable and customary
10 Claims Payment Comparison YouSharedPlan DeductibleCopayOOP MaxPlan Pays Market 500* (family) $1,00020%$3,000100% Value 750* (family) $1,50020%$6,000100% High Deductible (individual) $2,000 0%$2,000100% High Deductible (family) $4,000 0%$4,000 100% * Office visit co-pays, ER co-pays pharmacy co-pays not included
11 Market 500Value 750HDHP w/ HSA Premium (Month) Employee Employee + 1 Family $109.75 $219.50 $329.25 $58.75 $117.50 $176.25 $54.80 $109.60 $164.40 Medical Plan Premiums
12 Why is the Market 500 higher? We are self-insured. This means our rates are based on our volume of medical claims. Claims costs per employee for this option through July are considerably higher than the other options: $1,500/person for Market 400 versus $705/person for Value 750 Premiums adjusted based on option costs
13 Market 500Value 750HDHP w/ HSA Pharmacy Generic Brand (30%) Non-formulary (50%) Specialty (50%) Min Max Cost $10 $20 $40 $40 $80 $80 $160 Min Max Cost $10 $20 $40 $40 $80 $80 $160 You pay 100% of negotiated rate until you reach your deductible – then plan pays 100% Pharmacy Coverage
14 Pharmacy Example Example cost for non-formulary drug: Retail Drug Cost: $450 Aetna Negotiated Rate: $292 You pay: Market 500 (50%) $80 (ongoing) Value 750 (50%) $80 (ongoing) High Deductible* $292 * Pay full amount until deductible is met
15 Tax-free contributions to pay for current and/or future medical expenses Interest earned tax free Flexible – you choose when or whether to use the account for health care expense Banking services provided by JPMorgan Chase Bank. Some fees required. Easy access to funds through debit card Key Features of an HSA What is an HSA? It is a savings account that is owned by you and is associated with a High Deductible Health Plan
16 Includes expenses such as: Deductibles Coinsurance Not covered but eligible IRS expenses Prescription drugs It also includes expenses for: COBRA-continuation coverage Health plan coverage while receiving unemployment compensation Medicare premiums and out-of-pocket expenses Qualified long-term care insurance Employees are responsible for keeping all receipts and records, demonstrating that HSA dollars were used for qualified health care expenses. HSA Tax-Qualified Expenses
17 Changes for 2010: This is an employee-paid benefit You will be auto-enrolled for 50% coverage The Company will reimburse your premium No buy-up option Why the change? Since this is a post-tax benefit, you will not pay taxes on any amount you receive while on long- term disability. Long Term Disability Plan
18 For 2010, our disability and Family Medical Leave programs will be managed by UNUM Why the change? To gain consistency throughout the country. To better manage our disability programs. To employ expertise for managing FML program. Total Absence Management
19 For help with your benefit plan questions: October 2009 For Your Benefit newsletter 2010 Open Enrollment Guide (online) Aetna: Website Aetna Navigator Plan Selection and Cost Estimator Tool Customer Service line (plan questions) Benefits Connection (general benefits) Resources and Tools
20 You must enroll if: You want to change your medical plan You have a High Deductible Plan and want to put money into a Health Savings Account through payroll deduction You want to put pre-tax money into a Flexible Spending Account for Health Care or Dependent Care Do I need to enroll this year?
21 If you dont enroll, your benefit elections from last year continue, EXCEPT: Flexible Spending Account deductions go to $0 Health Savings Account deductions go to $0 You are automatically enrolled in Long Term Disability Those in the Market 400 plan in 2009 will be enrolled in the Market 500 plan for 2010 What if I dont Enroll?
22 To enroll online, you will need: your 6-digit employee ID (on your pay stub) Your PIN (Unless changed, PIN is last four digits of SSN) To enroll by phone: Call Benefits Connection weekdays between 8:00 am. And 5:00 p.m. Central time How and When to Enroll Enroll between October 28 and November 11
23 Make sure that your enrollment is correct. To do so: Print a copy of your enrollment elections at end of your online session In early December, confirmation statements will be sent to everyone by mail Review the statements carefully Call Benefits Connection by December 14 if you need to make corrections. What happens after I enroll?
24 2009 Incentive Program Ends November 30 Make sure you: Take your Health Assessment – learn about your health and earn $150 Review incentives on Aetna Navigator Complete programs by 11/30 to get an incentive Aetna tracks doctor, dental and program completion If you dont have our medical coverage, see me Watch for 2010 program details in December Incentive Program Status