Presentation is loading. Please wait.

Presentation is loading. Please wait.

© 2010 Wittenberg University Springfield, Ohio 45501 Benefits Open Enrollment Meeting Effective January 1, 2012.

Similar presentations


Presentation on theme: "© 2010 Wittenberg University Springfield, Ohio 45501 Benefits Open Enrollment Meeting Effective January 1, 2012."— Presentation transcript:

1 © 2010 Wittenberg University Springfield, Ohio 45501 Benefits Open Enrollment Meeting Effective January 1, 2012

2 © 2010 Wittenberg University Springfield, Ohio 45501 2 Agenda I.Review of the Year II.Medical Insurance  Plan Design Review- No plan changes  Contributions - Medical III.Dental Insurance  Plan Design Review- No plan changes  Dental separate from Medical effective 1/1/ 2012  Contributions- Dental IV.Vision Plan  Plan Design Review-No plan changes  Contributions- No changes V.Flexible Spending Account VI.Enrollment Process and Deadlines VII.Resources  www.anthem.com www.anthem.com  www.tasconline.com www.tasconline.com  Express Scripts Express Scripts  HR Webpage HR Webpage

3 © 2010 Wittenberg University Springfield, Ohio 45501 The Year in Review Total cost of medical claims for our renewal experience period: $1,484,925 Total cost of prescription drug claims: $863,814 Total Medical/Rx claims cost: $2,348,739 Total Cost of top 5 claims… $309,316 None of our high claimants exceeded our $125,000 stop loss limit

4 © 2010 Wittenberg University Springfield, Ohio 45501 The Year in Review Total cost of plan in 2010- $5,009,644 Projected cost of plan Oct 1, 2010- July 31, 2011 – $3,651,894 Actual cost of plan- $2,872,271 Projected 14% increase Oct. 2011 - note rates will stay same through calendar yr. and possibly through fiscal year.

5 © 2010 Wittenberg University Springfield, Ohio 45501 General Information Plan is Effective 01/01/2012 Self-Funded Plan subject to ERISA and plan document Partnering with Anthem Blue Cross & Blue Shield Blue Access PPO network – national network 4 Plan Types: Employee plan, Employee + spouse plan, Employee +children plan, & Family plan BIG CHANGE – Because of implications resulting from the Health Care Reform Act, it is necessary to split out the medical and dental premiums effective Jan. 1 2012.

6 © 2010 Wittenberg University Springfield, Ohio 45501 General Information Open Enrollment for 2011- Oct. 12 th - Nov. 11 th Qualifying Event – You can only join a plan or make benefit election changes during an open enrollment period unless you experience a qualifying life event change as defined by IRS. Examples: change in marital status, birth or adoption of a child, change in spouse’s employment status. You must contact Human Resources to complete an enrollment form within 31 days of the event.

7 © 2010 Wittenberg University Springfield, Ohio 45501 Glossary of Terms Co-pay – a flat dollar amount that is paid at the time of service. Co-pay does not apply to the deductible Deductible – annual amount of money a member must pay before benefits are paid at the co-insurance %. Co-insurance – a percentage that a member pays for services received after they have met their deductible. Member pays in full until deductible is met. Out-of- pocket limit – the most an employee would pay in deductible and co-insurance during a plan year (Jan-Dec) for healthcare services excluding prescription drugs. Services with a % = Co-insurance. Services with a $ = Co-pay.

8 © 2010 Wittenberg University Springfield, Ohio 45501 Wittenberg’s Blue Access PPO Health Plan MEMBER PAYS Deductible $400 individual /$800 family Emergency Room Services 10% after deductible In-Network Benefit Out-of-Pocket Limit $1,200 individual /$2,000 family Physician Office visits $20 co-pay Preventive Care visits Covered at 100% Urgent Care $20 co-pay Inpatient/Outpatient Services 10% after deductible

9 © 2010 Wittenberg University Springfield, Ohio 45501 Wittenberg’s PPO Health Plan Out-of-network benefit Out-of- Pocket Limit $1,300 individual /$2,200 family Physician Office visits 30% after deductible Preventive Care visits Urgent Care Inpatient/Outpatient Services Balance billing: Providers and hospitals who are out-of-network will bill you for the difference between the amount the plan pays and their billed charges.

10 © 2010 Wittenberg University Springfield, Ohio 45501 Deductibles and Out-of-Pocket Limit Deductible The $400/$800 deductible simultaneously applies to both in and out-of-network services. In other words, there is not a separate deductible for out-of-network. Out-of-Pocket Limit (“OOP”) There is a separate out-of-pocket limit for in-network and out-of-network co-insurance expenses. Co-insurance costs for services received in-network only apply to the in-network OOP. Co-insurance costs for services received out-of- network only apply to the out-of-network OOP. In-network - $1,200/$2,000 Out-of-network - $1,300/$2,200

11 © 2010 Wittenberg University Springfield, Ohio 45501 Wittenberg Prescription Benefit Prescription Drug Retail $10/$25/$40 Express Scripts Prescription Drug Mail Order $20/$50/$80 3-month supply Prescription co-pay OOP limit$1,200 single/$2,000 family Note: Prescription OOP limit is completely separate and unrelated to the OOP for medical.

12 © 2010 Wittenberg University Springfield, Ohio 45501 12 How to Find a Provider www.anthem.com Click on “Find a Doctor” in the middle of the page Choose the state that you want to search Choose a Plan (PPO) Choose the type of Provider you want to find You can then search by provider name, address, zip code, etc. Or call the customer service number listed on the back of your ID card

13 © 2010 Wittenberg University Springfield, Ohio 45501 13 Healthcare Reform Reminders Preventive care is covered at 100% (in network) Dependent children are eligible up to the end of the month in which they turn 26 Lifetime Maximum on the medical plan is unlimited No Pre-Existing condition clause for children under age 19

14 © 2010 Wittenberg University Springfield, Ohio 45501 14 Monthly Contributions- Medical No Cost Increase in Calendar Year 2011 Plan TypeTotal Cost Annual/Monthly Wittenberg 80% Annual/Monthly Employee 20% Annual/Monthly Single$5,556.00/$463.00$4,440.00/$370.00$1,116.00/$93.00 Employee Plus Spouse $13,884.00/$1,157.00$11,112.00/$926.00$2,772.00/$231.00 Employee Plus Children $13,428.00/$1,119.00$10,740.00/$895.00$2,688.00/$224.00 Family$20,688.00/$1,724.00$16,548.00/$1,379.00$4,140.00/$345.00

15 © 2010 Wittenberg University Springfield, Ohio 45501 Wittenberg Dental Blue Complete Plan MEMBER PAYS Deductible $25 single /$75 family Annual Maximum (per covered member) $1,500 Diagnostic and Preventive No Charge to member Minor Restorative 20% after deductible Oral Surgery 20% after deductible Endodontic Services 20% after deductible Periodontal Services 20% after deductible Prosthodontic Services 50% after deductible Orthodontic Services 50% no deductible Orthodontic Lifetime Maximum $1,000 Orthodontic Age Limit Child to age 19

16 © 2010 Wittenberg University Springfield, Ohio 45501 16 Monthly Contributions- Dental No Cost Increase in Calendar Year 2011 Plan TypeTotal Monthly CostWittenberg 80%Employee 20% Single$25.00$20.00$5.00 Employee Plus Spouse $62.00$50.00$12.00 Employee Plus Children $59.00$47.00$12.00 Family$91.00$73.00$18.00

17 © 2010 Wittenberg University Springfield, Ohio 45501 Managing Health Care Costs Use in-network providers whenever possible. Take advantage of preventive care benefits. Schedule an annual physical every year. Only use the Emergency Room for Life Threatening Emergencies. Utilize Urgent Care centers or Convenience Care Clinics after hours for non-emergency situations. If you are scheduling tests such as: X-Ray/MRI/CT scan use free-standing facilities verses hospitals when available. Take advantage of the retail prescription discount programs such as the $4 offerings at Wal-Mart, Target, Kroger etc. Use Mail order for Maintenance medications.

18 © 2010 Wittenberg University Springfield, Ohio 45501 Claims Assistance If you are having trouble resolving a claim issue USI Insurance can assist you. If after you have reached out to Anthem your questions were not answered or it is a complex claim issue please contact Paula Meyers at 1-877-778-7469 or you can email her at paula.meyers@usi.biz.

19 © 2010 Wittenberg University Springfield, Ohio 45501 Anthem Blue View Vision Benefit Plan for Active Employees Network Benefits Routine Eye Exam (once every 12 months) $10 co-pay Eyeglass Frames (once every 24 months) $100 allowance/20% off the remaining balance Eyeglass Lenses (standard) Standard Plastic Single vision lenses (1 pair) $15 co-pay, then covered in full Standard Plastic Bifocal lenses (1 pair) $15 co-pay, then covered in full Standard Plastic Trifocal lenses (1 pair) $15 co-pay, then covered in full Eyeglass lens upgrades UV coating, Tint, Standard Scratch-Resistance $15 co-pay per upgrade Standard Polycarbonate $40 co-pay Standard Progressive $65 co-pay standard Anti reflective coating $45 co-pay Other add-ons and services 20% off retail price Contact Lenses Elective Conventional Lenses $105 allowance/15% off the remaining balance Elective Disposable Lenses $105 allowance (no add’l discount) Non-Elective contact Lenses Covered in Full

20 © 2010 Wittenberg University Springfield, Ohio 45501 Active Employee Monthly Contributions Vision Plan Plan Type Employee Monthly Single $3.00 Employee Plus One $6.00 Family $10.00 Contributions are tax -sheltered

21 © 2010 Wittenberg University Springfield, Ohio 45501 Flexible Spending Account (FSA) TASC Third Party Administrator tasconline.com By using PRE-TAX dollars, Flexible Spending Accounts help you take advantage of tax savings on eligible health care and dependent care expenses. Wittenberg offers you two reimbursement accounts: 1. Health Care Reimbursement Account (for your eligible health care expenses not covered by insurance) 2. Dependent Care Reimbursement Account (for reimbursement of day care expenses for eligible dependents).

22 © 2010 Wittenberg University Springfield, Ohio 45501 FSA - What is it? You set aside funds in an FSA to cover your out-of -pocket medical or dependent care costs. You need to decide upfront how much money you want to elect for the calendar year. Voluntary election of payroll deductions on a pre-tax basis. Savings of nearly 30% is the Rule of Thumb – Use the TASC On-line Tax Savings Calculator to estimate your tax savings. http://www.tasconline.com/buytasc/flexsystem/http://www.tasconline.com/buytasc/flexsystem/ You cannot change your election unless you have a qualifying event. Also, you cannot transfer money from one account to another. “Use it or Lose it” - You have a grace period of three months after the end of the calendar year to submit claims for eligible expenses incurred during the previous calendar year. Any money left in your account after the three months will be forfeited.

23 © 2010 Wittenberg University Springfield, Ohio 45501 FSA – Enroll Now for Jan. 1, 2012 effective date Healthcare FSA $3,000 annual maximum limit You have immediate access to your full election at the onset of the calendar year even though the full election has not been deducted from your pay.

24 © 2010 Wittenberg University Springfield, Ohio 45501 FSA - Enroll Now for Jan. 1, 2012 effective date Dependent Care FSA If married, spouse must work or attend school full-time Maximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return Under IRS guidelines, you can only be reimbursed for dependent care that has already taken place. Also, you can only be reimbursed for the amount you have already contributed to your dependent care FSA. Eligible expenses include dependent care expenses for children under age 13, a disabled spouse, and/or a disabled relative or household member who depends on the account holder for at least half of his or her support.

25 © 2010 Wittenberg University Springfield, Ohio 45501 FSA Reimbursement You can request reimbursement by Fax – 608-663-2762 Mail – TASC, P.O. Box 7308, Madison, WI 53707-7308 On-line – www.tasconline.comwww.tasconline.com 24-hour turnaround on reimbursements via Direct Deposit. Use the FlexSystem Claim Card for seamless real-time payments. You can also order a card for your spouse. Instant account status availability on-line or via FlexSystem’s voice response system. Toll-free customer service assistance 800-422-4661

26 © 2010 Wittenberg University Springfield, Ohio 45501 FSA Card How to use your Claim Card: You may use the card like a credit card when you pay for eligible expenses at the point of service. The funds are automatically deducted from your Flex Account balance. It is important to remember that you may still need to submit substantiation upon request. Where to use the card: Medical and dental physicians Vision care providers Medical facilities Drug stores and in-store pharmacies Hospitals including emergency rooms Dependent care providers who accept Visa

27 © 2010 Wittenberg University Springfield, Ohio 45501 27 Medical, Dental and Vision Open Enrollment You need to complete an enrollment form if:  You want to enroll in the Medical, Dental or Vision Insurance programs for the first time  You want to add or drop your spouse or dependents from your coverage  You want to cancel your one or more of the plans your currently participate in You DO NOT need to complete any paperwork if:  You are currently enrolled in the medical and dental plan; want to remain on both plans and do not want to add or drop your spouse or dependents Reminder: Employees can enroll in Medical and/or Dental independently. DEADLINE TO TURN IN FORMS IS NOVEMBER 11th. New Anthem ID cards will be mailed to your home addresses.

28 © 2010 Wittenberg University Springfield, Ohio 45501 FSA Open Enrollment  Anyone who wants to participate in an FSA must enroll or re-enroll for 2012.  If you were enrolled in 2011, an email will be sent to you with re-enrollment information and you can re-enroll online. If you are enrolling for the first time, you’ll need to complete a paper enrollment form. Enrollment DEADLINE IS NOVEMBER 11th. If you are re-enrolling please keep your existing TASC cards (no new cards will be sent). New enrollees will get an email about the card and information will be mailed to your home address about 10 days after enrolling.

29 © 2010 Wittenberg University Springfield, Ohio 45501 29 Questions? THANK YOU FOR YOUR TIME!


Download ppt "© 2010 Wittenberg University Springfield, Ohio 45501 Benefits Open Enrollment Meeting Effective January 1, 2012."

Similar presentations


Ads by Google