2017 Annual Benefits Open Enrollment Overview : UHC Plan - - PowerPoint PPT Presentation

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2017 annual benefits open enrollment overview uhc plan
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2017 Annual Benefits Open Enrollment Overview : UHC Plan - - PowerPoint PPT Presentation

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2017 Annual Benefits Open Enrollment Overview : UHC Plan Performance Past years - 2011 Joined UHC, 20% decrease in cost from Anthem 2012 0% premium increase, low loss ratio 2013 5% premium increase 2014

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2017 Annual Benefits Open Enrollment

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  • Past years -

– 2011 – Joined UHC, 20% decrease in cost from Anthem – 2012 – 0% premium increase, low loss ratio – 2013 – 5% premium increase – 2014 – 3.84% premium increase – 2015 – 3.5% premium increase, SFMC becomes network provider – 2016 – 0% premium increase, low loss ratio

  • Recent concerns –

– Last twelve months of claims – 93% loss ratio (85% or lower is ideal)

  • Increased Rx claims
  • Increased outpatient claims
  • Accelerated Plan ($500 deductible) loss ratio – 127%

– MOSERS FY18 contribution rate increases by 2%+ = $1.025 million cost increase

  • Priority going forward – affordable health care for employees,

families and University

Overview : UHC Plan Performance

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  • 11.7% increase in premium
  • University will continue to pay 100% of Base Plan

employee only premium

  • Increase in Rx copays for Accelerated Plan only

– $15/40/75 tier change

  • University not passing on increased cost for

employee only premium at this time. However, there is an immediate need to identify cost control strategies:

– Begin efforts to assess feasibility of self-insurance – Wellness programming tie to health insurance benefits

UnitedHealthcare Renew al

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  • University will continue to provide:

– Base Plan dependent premium supplements – Cafeteria plan funding

  • Employee premium cost share levels for

Accelerated Plan remain the same

UnitedHealthcare Renew al

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  • Medical Insurance – UHC

– 11.7% premium increase – Base Plan ($1,500 deductible)

  • University will provide 100% paid employee only coverage
  • University will continue to provide dependent premium supplements at

same levels – $125/month for spouse coverage – $175/month for children coverage – $325/month for family coverage

  • University will continue to provide $750 cafeteria plan funding

– Accelerated Plan ($500 deductible)

  • Rx copay increase to $15/$40/$75 tiers
  • Employee cost share premium levels remain the same
  • University will continue to provide $250 cafeteria plan funding

2017 Insurance Highlights

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  • Vision insurance
  • VSP (Vision Service Plan)
  • Plan B – frame allowance increases to $160
  • No change in premiums
  • Dental Insurance
  • Delta Dental of MO
  • No change in coverage or premiums
  • Flexible Spending Accounts (MRA and Dependent Care

Assistance)

  • HealthSMART Benefit Solutions

2017 Insurance Highlights

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  • Base Plan

– Employee between 75% and 100% FTE, University will fund 100% premium – Employee between 50% and 74% FTE, University will fund 70% of premium – $750/year in cafeteria plan funding (Pro-rated for part time employees based on percent of assignment) – Deductibles - $1,500 individual/$3,000 family – Out of Pocket Maximums –

  • $5,000 individual/$6,850 family (HSA plan)
  • $5,000 individual/$10,000 family (MRA plan)

– Rx Copays - after deductible is met

  • $10/$35/$60 retail pharmacy
  • $25/$87.50/$150 mail order pharmacy

– University-paid supplement for dependent premiums

  • Spouse = $125/month
  • Child(ren) = $175/month
  • Family = $325/month

– Health Savings Account (HSA) option available

  • Family members required to meet family deductible

– Medical Reimbursement Account (MRA) option available

  • Family members can meet individual deductible

2017 Medical Insurance

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  • Accelerated Plan

– Employee contribution to employee premium based on Medicare wages, reported in Box 5 of the 2015 W-2 (Part time employees 75% and greater will have an annualized Medicare wage) – Employee between 50% and 74% FTE, University will fund 70% of premium – $250/year in cafeteria plan funding (Pro-rated for part time employees based on percent of assignment) – Deductibles - $500 individual/$1,000 family – Out of Pocket Maximums - $3,500 individual/$6,850 family – Rx copays - not subject to deductible or cost share

  • $15/$40/$75 retail pharmacy
  • $37.50/$100/$187.50 mail order pharmacy

– Medical Reimbursement Account (MRA) - only option available

2017 Medical Insurance

<$27,000 $27,000 - $44,999 $45,000 - $69,999 $70,000 + $22/month $45/month $67/month $90/month

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2017 Medical Insurance Employee Monthly Premiums

UnitedHealthcare Base Plan UnitedHealthcare Accelerated Plan

Monthly Premium

(net of dependent supplement)

Dependent Supplement Monthly Premium Employee $0* Employee $22- $90** Spouse $383.04 $125/mo Spouse $648.43 Child(ren) $240.67 $175/mo Child(ren) $530.52 Family $552.52 $325/mo Family $1,120.00 *100% Paid by University **based on Medicare wages

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  • Base Plan - $750

– Will apply funding to: employee portion of medical premiums (part-time employees only), health savings account (HSA), dependent medical premiums, vision and dental premiums, and dependent care assistance and medical reimbursement account

  • Accelerated Plan - $250

– Will apply funding to: employee’s portion of medical premium

  • Prorated funding for part-time employees based on

percentage of assignment

2017 Medical Insurance

Cafeteria Plan Funding

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  • Available with Base Medical Plan coverage
  • OptumHealth Bank

(www.optumhealthbank.com)

  • Account features:

– Balances roll over year after year – Interest-bearing – Portable

  • Use to pay for qualified medical expenses

Health Savings Account (HSA)

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  • IRS Eligibility Rules -

– Covered by a high deductible health plan – Cannot be covered by any other health plan that is a low deductible health plan (individual deductible must be at least $1,300) – Cannot be drawing Medicare benefits – Cannot be claimed as a dependent on someone else’s tax return – Employees who have received VA benefits in past three months (some exceptions)

Health Savings Account (HSA)

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  • Contributions

– Both employer and employee contributions are permissible – Employer contribution via Cafeteria Plan funding

  • ½ of annual employer-funded amount contributed in January

with remaining ½ contributed February - December

– 2017 maximum contribution levels:

  • Single Coverage = $3,400
  • Family Coverage = $6,750

– 2017 Age 55+ Catch Up: Additional $1,000

Health Savings Account (HSA)

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  • Distributions

– Tax-free if used to pay for qualified medical expenses – Monies must be available in account at time of distribution – Use for qualified expenses incurred on or after account is opened – Can apply qualified medical expenses of spouse and children, even if not covered by your medical insurance

Health Savings Account (HSA)

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  • Distributions

– Qualified Medical Expenses:

  • Deductibles
  • Cost Shares
  • Out of pocket costs on medical claims
  • Over-the-counter medical items
  • Medicare insurance premiums
  • COBRA premiums
  • Long Term Care insurance premiums (based on federal tax

deductible limits)

  • Patient Protection and Affordable Care Act legislation –

Requires a doctor’s prescription for over-the-counter medical items. Keep copies for your records.

Health Savings Account (HSA)

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  • Serviced through OptumHealth Bank
  • If electing HSA for first time:

– Activate your account via portal login – After activation, Welcome Kits will be mailed to members

  • For current OptumHealth Bank HSA holders:

– Existing bank account will continue to be used

  • Optional mutual fund investment

– Account balance threshold - $2,000 – To waive investment fee charges, enroll in the eSaver product by calling 1- 800-791-9361, option 0

  • All set up and monthly fees paid by University while having Base Plan

medical coverage

  • OptumHealth Bank: 1-800-791-9361 or 1-866-234-8913

Health Savings Account (HSA)

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  • Medical Reimbursement Account (MRA)

– Available for both Base Plan and Accelerated Plan – Monies can be claimed immediately – “Use or Lose” feature, no roll over

  • Dependent Care Assistance Account

– Available for both Base Plan and Accelerated Plan – Monies must be available in the account in order to claim reimbursement – “Use or Lose” feature, no roll over

  • 2017 Annual Contribution Maximums:

– MRA - $2,600 – Dependent Care Assistance - $5,000

2017 Flexible Spending Accounts

(MRA and Dependent Care Assistance)

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HealthSMART

Website Login –

https://maa-tpa.lh1ondemand.com/Login.aspx Contact Information: – Phone: 1-800-824-5034 – Fax: 1-866-513-9681 – Email: April.tennell@healthsmart.com

2017 Flexible Spending Accounts

(MRA and Dependent Care Assistance)

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  • Remember: File claims using UHC insurance card before using MRA debit

card!

  • Can apply qualified medical expenses of spouse and children, even if not

covered by your medical insurance

  • Direct Deposit available – HealthSMART Direct Deposit Authorization form
  • n HR website
  • Substantiation of claims may be required per IRS guidelines
  • Patient Protection and Affordable Care Act legislation – will require a

doctor’s prescription to accompany a reimbursement claim for some over- the-counter medical items, typically “medication” items

2017 Flexible Spending Accounts

(MRA and Dependent Care Assistance)

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Dental Insurance – Delta Dental of Missouri

Plan A-Low Option Plan B-High Option

Employee $13.18 Employee $ 30.46 Employee + Spouse $28.26 Employee + Spouse $ 60.12 Employee + Children $43.88 Employee + Children $ 76.22 Employee + Family $58.10 Employee + Family $109.80

Vision Insurance – Vision Service Plan (VSP)

Plan A-Exam Plus Plan B-Signature Plan

Employee $3.05 Employee $11.44 Employee + Spouse $4.30 Employee + Spouse $18.35 Employee + Children $4.37 Employee + Children $18.73 Employee + Family $6.46 Employee + Family $30.22

2017 Dental and Vision Insurance

Monthly Premiums

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  • November 7 – 18, 2016
  • Full-time and part-time (50% assignment or greater)

employees will once again use Employee Self Service to process open enrollment elections

  • Dually employed spouse employees enrollment

– Definition: Both spouses employed by Southeast with children coverage and can take advantage of the family deductible requirement – Will receive enrollment forms via email for completion and return to HR by November 18

2017 Open Enrollment

Processing your enrollment

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2017 Open Labs Schedule

Date Time Location Tuesday, November 8 10:00 am – 12:00 pm Dempster 003 Wednesday, November 9 9:00 – 11:00 am Dempster 003 Friday, November 11 9:00 – 11:00 am Dempster 003 Tuesday, November 15 2:00 – 4:00 pm Dempster 003 Wednesday, November 16 1:30 – 3:30 pm Dempster 003 Friday, November 18 9:00-11:00 am Dempster 003

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Location: Academic Hall 012 Daphine Buerck, HR Specialist: x7365 Dana Seabaugh, HR Specialist: x5096 Leann Stinson, HR Specialist: x2080 http://www.semo.edu/hr/benefits Chat with an HR representative: http://www.semo.edu/mibew

Human Resources

Contact Information