Presentation on theme: "Antioch University Open Enrollment Presentation"— Presentation transcript:
1 Antioch University Open Enrollment Presentation November, 2010
2 Medical Benefits - What are my options? Benefit options for 2011:Anthem PPO PlanAnthem Lumenos Health Savings Account (HSA)
3 Your 2011 Anthem PPO Plan PPO Medical Benefits Network Benefits Deductible$400/$800Coinsurance85% Plan, 15% MemberOut of Pocket Maximum$800/$1,600Office Visits$20 copayPreventive Care, not DiagnosticEmergency Room$75Urgent CareAll Other Covered ExpensesDeductible + 15%These benefits denote in-network coverage. Please refer to the complete benefit summary for out-of-network benefits and other benefit details which differ from the amounts noted above.
5 HSA – How It Works + High Deductible Insurance Health Savings Account Protects you from bigMedical billsHighDeductibleInsuranceHelps pay your deductibleHealthSavingsAccountPlan+Tax-deductible depositsHealthSavingsAccountTax-deferred growthTax-free for medical care
6 Opening Your Health Savings Account Banks, credit unions, insurance companies and other financial institutions are permitted to be trustees or custodians of these accounts. YOU MUST OPEN YOUR OWN HSA ACCOUNT to deposit your HSA Contributions. Account should be open before 1/1/2011.If you cannot locate a local institution willing to establish your account, try visiting a link recommended by the U.S. Department of the Treasury.
7 HSA – Who can not have one? Anyone can enroll in the HSA plan, but you can not open the HSA bank account if you are:Enrolled in MedicareEnrolled in any other health plan that is not an HSA compatible health planActive in the militaryClaimed as a dependent on another individual’s tax returnThe IRS has specific rules on who can open an HSA.
8 HSA Eligible ExpensesThe IRS determines which health care services are eligible for reimbursement by your HSA, up to $3,050 single and $6,150 family. Examples of eligible expenses are:Medical services applied to your deductible or out of pocket maximum under your Anthem HSA planOTC medications with a prescriptionDental expensesVision Expenses(Medical expenses incurred by or on behalf of domestic partners or their children are ineligible for tax-free reimbursement from an HSA, unless the domestic partner qualifies as a dependent under IRC section 152.)A Limited Purpose FSA can be set up for dental or vision expenses not reimbursed through HSA. Infrequently selected, this option is normally chosen when high-dollar expenses are being expected (braces, laser vision correction) and plan members want to protect their HSA dollars.
9 HSA Contributions Antioch University - Annual Contributions: * January: $300 Contribution, April – December: $100/mo ** January: $600 Contribution, April – December: $200/mo.2011 Annual HSA Contribution Maximums(includes Antioch University Contributions):Single: $3,050Family: $6,150Catch Up Provision for those that are 55+ is $1,000 for 2011.Employee$1,200*Employee + 1$2,400**Employee + 2 or More
10 Your 2011 Anthem HSA PlanEnrolling in this plan gives you the opportunity to open a Health Savings Account (HSA) and enjoy lower payroll contributionsHSA Medical BenefitsNetwork BenefitsDeductible$2,500/$5,000Coinsurance100% Plan, 0% MemberOut of Pocket MaximumAfter deductible is met, rx copays apply$3,500/$7,000Office VisitsDeductible + 0%Preventive Care, not Diagnostic100%, no DeductibleEmergency RoomUrgent CareAll Other Covered Expenses
11 HSA Prescription Benefits Your 2011 Anthem HSA PlanAfter deductible is met, the following copays apply for all prescriptions until your copays equal $1,000 (single) and $2,000 (family) out of pocket.HSA Prescription BenefitsRetail Tier 1$10 copayTier 2$30 copayTier 3$50 copay30 Day Supply Tier 425% up to $150 maximumMail Tier 1$75 copay$150 copay
12 Health Savings Account – IRS Limits for 2011 Single FamilyCoverage CoverageAnnual HSA Contribution Max $3,050 $6,150These limits apply to the combined employer and employee contributionsLimited Purpose FSA Contribution Max $4, $4,000Catch-Up Contribution $1,000 $1,000Allowed if age 55 +
13 Earn Rewards – HSA Participants Only Earn gift card reward dollars for activities that contribute to your health and well-being:$50 for completing the online MyHealth Assessment (one per family)$100 for enrolling in a health coaching program for an eligible condition (per qualified family member)$200 for graduating from a health coaching program for an eligible condition (per qualified family member)$50 for completing the Healthy Lifestyles: Tobacco-Free Program (per qualified employee and/or spouse)$50 for completing the Healthy Lifestyles: Healthy Weight Program (per qualified employee and/or spouse)Our strategy with Anthem’s Lumenos plans is based on a philosophy of health improvement. We want you to first and foremost understand your health and health risk factors. That’s why we created incentives to complete the MyHealth Assessment – it’s a critical first step. The goal is to assist those with low health risk factors to stay low risk and we want those with a higher health risk level to decrease their risk factors. Most of our products include Healthy Reward incentives.Healthy Rewards incentives are used to motivate people to get healthy and stay healthy. You may earn rewards for using certain tools and services that help maintain and improve your health. Examples of Healthy Rewards incentives include rewards for completing the on-line MyHealth Assessment, enrolling and completing the Personal Coach Program, completing the Tobacco Treatment Program or the Weight Management Program. For the Health Coach Program, there are Healthy Rewards incentives for both enrolling in the program and for completing it.Incentives come in the form of gift cards that typically range from fifty dollars to two hundred dollars. Gift cards can then be redeemed at select health-focused retailers. Let’s take a look at how to redeem your Healthy Reward incentives.
14 Redeem Rewards – HSA Participants Only Redeem your rewards dollars for gift cards to select health-focused retailers like:Dick’s Sporting GoodsFoot LockerThe Athlete’s FootCity SportsAnd MoreThe process is simple:Earn your reward dollarsReceive a letter from IncentOne, which includes a code and password and instructions for redeeming your gift card reward online or by phoneSelect from available retailers and redeem your gift card rewardReceive your gift card by mailYou can redeem your Healthy Rewards for gift cards to the following retailers. The gift cards may be used to purchase merchandise at retail locations or online for companies with online shopping available.Bally Sports ClubsBally Total FitnessCVSDick’s Sporting GoodsFoot ActionFoot LockerHoMedicsModells.comWhen you earn Healthy Rewards, you receive a letter at home from our partner, IncentOne, with a unique code and password. You can then redeem the incentive online or by phone for a gift card from the above list of select retailers, and the gift card will be mailed to you.While the gift cards function just like cash to purchase merchandise from the chosen retailer, they cannot be redeemed by the retailer for cash. Healthy Rewards and redemption certificates do not expire, but the actual, redeemed gift cards could expire based on the individual terms and conditions of the selected retailer. You can save up your Healthy Rewards and redeem them at a later date for one gift card in a larger amount or split out your Healthy Rewards dollars across multiple retailers. Finally, you can give the gift card to someone else - you can even have the gift card mailed directly to someone else at the time of redemption.Gift cards constitute taxable income to the recipient. If the gift cards are used for qualified medical expenses, the individual might qualify for an itemized deduction for medical expenses.Spa FinderSportsChalet.comSportMart.comThe Sports AuthorityVitacost.comDunhamsports.comFruit of the Month ClubKids Foot Locker
15 Two Fundamental Questions How much do I have to pay out of my pocket when I use the health insurance plan?How much does the health insurance plan cost out of my paycheck?
16 How much do I pay when I use the insurance? Network Medical BenefitsPPOHSADeductible$400/$800$2,500/$5,000Coinsurance15%0%Out of Pocket MaximumAfter Antioch HSA Contribution$800/$1,600$3,500/$7,000$2,300/$4,600Office Visits$20 copayDeductible + 0%Preventive Care, not Diagnostic100% - No DeductibleEmergency Room$75Urgent CareAll Other Covered ExpensesDeductible + 15%These benefits denote in-network coverage. Please refer to the complete benefit summary for out-of-network benefits and other benefit details which differ from the amounts noted above.
17 How much do I pay when I use the insurance? Prescription BenefitsPPOHSAOut-of-Pocket ApplicationCopays do not apply to Out-of Pocket MaxCopays apply after deductible, until $1,000/$2,000 copay max, then 100% coverageRetail Tier 1$10 copayTier 2$30 copayTier 3$40 copay$50 copay30 Day Supply Tier 4See Tier 325% up to $150 maxMail Tier 1$20 copay$75 copay$70 copay$150 copay
18 How much do I pay to have the insurance? Bi-Weekly Contributions:PPOHSAEmployee Only$57.34$46.39Employee + 1$124.21$94.65Employee + 2 or More$185.08$143.83Monthly Contributions:$124.24$100.52$269.14$205.08$401.01$311.63
19 Anthem’s Online Health Tools MyHealth AssessmentPreventive Care GuidesMyHealth RecordCondition CentersSurgical Guides and Hospital ComparisonsTraditional and Alternative Health LibraryAnd moreBe sure to mention:The preventive care guides show you what’s recommended for people of your age and gender. You can print them and take them with you to your doctor.
20 Flexible Spending Account vs. HSA Health Savings AccountNo use-it-or-lose-itNo election requiredPortableUse of accumulated account balance onlyYou have total controlMust be in a HDHPIRS Form 8889Flexible Spending Account orLimited Purpose FSAUse-it-or-lose-itClaim must be filedAnnual binding electionNot portableAccess to entire elected amount immediatelyAny IRS-approved health expense
21 Open Enrollment Procedures Review your enrollment package thoroughly.If you are making any changes to your current Anthem medical election or dental benefits administered by MedBen, you MUST complete an enrollment form.In order to participate in the FSA or Limited Purpose FSA benefits, you MUST complete an enrollment form.Forms are available in the HR Office and must be completed no later than December 3, 2010.