Benefits Open Enrollment November 1 st through November 15 th Jason - - PowerPoint PPT Presentation
Benefits Open Enrollment November 1 st through November 15 th Jason Dempster Associate Director of Compensation & Benefits Kelly Fang Well-being Program Manager and Certified Wellness Coach Todays Focus Dental Plan Renewal Health
Jason Dempster
Associate Director of Compensation & Benefits
Kelly Fang
Well-being Program Manager and Certified Wellness Coach
Dental Plan Renewal Health Plan Renewal New Benefit Offering Life, Long-term Disability Wellness & Health at Macalester Online Benefit Enrollment System Questions and Answers
Vendor Design Structure Network
Service/Feature PPO Delta Premier Out of Network Annual Maximum Benefit Unlimited Unlimited Unlimited Annual Deductible $0 $0 $0 Diagnostic & Preventive
Exams, cleanings, x-rays, sealants
Preventive Dental
Covered at 100% Covered at 100% Covered at 100%
Type % of Expected Admin Trend Total Preventive 103% 0.0% 3.4% 106.4%
Tier
Per EE Premium
EE Only
$4.36
EE+1
$13.10
EE+(2+)
$20.41
Current Preventive Dental Rates
Per EE Premium $ Change per Mo % Change
$4.40 $0.04 1% $12.60
$21.00 $0.59 3%
2020 Preventive Dental Rates
Service/Feature PPO Delta Premier Out of Network Annual Max Benefit $1500/$2,000 $1,250/$1,500 $1,000 Annual Deductible $0/person; $25/person; $50/person;
Not applicable to preventive and diagnostics
$0/family $75/family $150/family Diagnostic & Preventive
Exams, cleanings, x-rays, sealants
Basic Services
Fillings, Emergency treatment for pain
Endodontics, Periodontics
Root canals
Oral Surgery
Extractions
Prosthetics
Denture adjustments, repairs
Major Restoratives
Dentures, Resins, Crowns
Orthodontics
$1,000 lifetime maximum
Covered at 100% Covered at 50% Covered at 50% Not Covered Covered at 75% Covered at 50% Covered at 50% Covered at 50% Covered at 50% Not Covered
Comprehensive Dental
Covered at 50% Covered at 50% Not Covered Covered at 80% Covered at 50% Covered at 50% Covered at 75% Covered at 50% Covered at 50% Covered at 100% Covered at 100% Tier
Per EE Premium
EE Only
$24.53
EE+1
$57.71
EE+(2+)
$92.44
Current Comprehensive Dental Rates
Per EE Premium $ Change per Mo % Change
$24.00
$57.40
$98.00 $5.56 6%
2020 Comprehensive Dental Rates
Type % of Expected Admin Trend Total Comprehensive 92% 0.0% 2.3% 94.3%
(sin (since 201 2013)
0.00% 0.00%
3.00% 26.61% 1.50%
2.02%
0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 2013 2014 2015 2016 2017 2018 2019 2020
80.0 90.0 100.0 110.0 120.0 130.0 140.0 150.0 2013 2014 2015 2016 2017 2018 2019 2020
Comp EE+2+ Comp EE+1 Comp EE Prev EE+2+ Prev EE+1 Prev EE Nat'l Avg
National Average = 5.6%
COVERAGE FOR:
In-Network* Out-of-Network In-Network* Out-of-Network Single $3,200/person $12,800/person $500/person $2,000/person Family $6,400/family $25,600/family $1,000/Family $4,000/Family PREVENTIVE CARE SERVICES Routine Health Exams, Cancer Screening, Eye and Hearing Exams, Immunizations, Prenatal & Postnatal Services 100% of charges incurred 100% of charges incurred 100 % of charges incurred No coverage CONVENIENCE CLINICS Minute Clinic ALLERG Y INJECTIONS Deductible, then 100% Deductible, then 100% No out of pocket cost 60% of charges incurred PRIMARY CARE OF F ICE VISITS MD Visits (includes ancillary services received in provider’s office and palliative care) BEHAVIORAL HEALTH/SUBSTANCE ABUSE - Outpatient Deductible, then 100% Deductible, then 100% $30 co-pay, then 100% 60% of charges incurred URG ENT CARE VISITS Deductible, then 100% Deductible, then 100% $50 co-pay, then 100% $50 co-pay, then 100% SPECIALTY OF F ICE VISITS Chiropractic, Physical Therapy, Speech Therapy, Occupational Therapy, Acupuncture, etc. AMBULANCE SERVICES Deductible, then 100% Deductible, then 100% 80% of charges incurred 60% of charges incurred INPATIENT HOSPITALIZATION Deductible, then 100% Deductible, then 100% 80% of charges incurred 60% of charges incurred EMERG ENCY ROOM VISITS (coverage for emergency conditions only) Single - Medical $3,200/person $12,800/person $3,200/person $12,800/person Family Medical $6,400/family $25,600/family $6,400/family $25,600/family G eneric F
Deductible, then 100% Deductible, then 100% $15 co-pay and then 100% thereafter 60% of charges incurred Brand F
Deductible, then 100% Deductible, then 100% $40 co-pay and then 100% thereafter 60% of charges incurred Specialty Drugs - Brand Non-F
Deductible, then 100% Deductible, then 100% 20% co-pay up to $300 per perscription, 100% covered thereafter 60% of charges incurred Mail Order - G eneric F
Deductible, then 100% Deductible, then 100% $30 co-pay and then 100% thereafter 60% of charges incurred Mail Order - Brand F
Deductible, then 100% Deductible, then 100% $80 co-pay and then 100% thereafter 60% of charges incurred OTHER COVERED SERVICES Deductible, then 100% Deductible, then 100% 80% of charges incurred 60% of charges incurred LIF ETIME MAXIMUM Unlimited $1,000,000 Unlimited $1,000,000 ANNUAL OUT-OF
PRESCRIPTION DRUG S Deductible, then 100% Deductible, then 100% $50 co-pay, then 100% $50 co-pay, then 100% Deductible, then 100% Deductible, then 100% $100 co-pay, then 100% $100 co-pay, then 100% Deductible, then 100% Deductible, then 100% $10 co-pay, then 100% 60% of charges incurred Deductible, then 100% Deductible, then 100% $30 co-pay, then 100% 60% of charges incurred
HDHP (2020) PPO (2020)
CALENDAR YEAR DEDUCTIBLE E-visits - virtuwell Deductible, then 100% Deductible, then 100% The first 3 visits free, then $10 co-pay per visit thereafter No coverage
Year Deductible Out-of-Pocket Max 2012 $2,400/$4,800 $2,400/$4,800 2013 $2,500/$5,000 $2,500/$5,000 2014 $2,600/$5,200 $2,600/$5,200 2015 $2,600/$5,200 $2,600/$5,200 2016 $3,000/$6,000 $3,000/$6,000 2017 $3,000/$6,000 $3,000/$6,000
Deductible
Mac Contribution
Adjusted Deductible
2018 $3,200/$6,400 $3,200/$6,400 2019 $3,200/$6,400 $3,200/$6,400
Deductible
Mac Contribution
Adjusted Deductible
2020 $3,200/$6,400 $3,200/$6,400
Contributions are made on a “pre-tax” basis through payroll deductions Health Savings Accounts are
to those who have elected the High Deductible Health Plan (HDHP) Macalester highly funds HSA’s through employer contributions to your HSA account A HSA is a true savings account Does not have the “use it or lose it” clause
Mac Monthly Contribution Level 1 EE Monthly Contribution Level 1 $100.00 $0.00 $200.00 $0.00 $200.00 $0.00 Mac Monthly Contribution Level 2 EE Monthly Contribution Level 2 $121.75 $21.75 $243.50 $43.50 $243.50 $43.50 Mac Monthly Contribution Level 3 EE Monthly Contribution Level 3 $143.50 $43.50 $287.00 $87.00 $287.00 $87.00
Open enrollment is an ideal time to review and update your HSA contributions
2020 Full-Time HSA Contributions
Max Matched Mac Contribution Annual Out-of-Pocket Maximum 2020 IRS Limits Max Amount for Unmatched Contribution Employee Only $2,244 $3,200 $3,550 $1,306 Family $4,488 $6,400 $7,100 $2,612
Open enrollment is an ideal time to review and update your HSA contributions
Part-Time .50-.74 FTE Employee Only Employee + (1) Employee + (2+) Mac Monthly Contribution Level 1 EE Monthly Contribution Level 1 $80.00 $0.00 $160.00 $0.00 $160.00 $0.00 Mac Monthly Contribution Level 2 EE Monthly Contribution Level 2 $90.88 $10.88 $181.75 $21.75 $181.75 $21.75 Mac Monthly Contribution Level 3 EE Monthly Contribution Level 3 $101.75 $21.75 $203.50 $43.50 $203.50 $43.50
2020 Part-Time HSA Contributions Max Matched Mac Contribution Annual Out-of-Pocket Maximum 2020 IRS Limits Max Amount for Unmatched Contribution Employee Only $1,482 $3,200 $3,550 $2,068 Family $2,964 $6,400 $7,100 $4,136
Admin 3.19% 3.19% Trend 3.22% 2.44% Regression 3.48% 3.48% Reserve
Inpatient Hospital
Outpatient Hospital
Pharmacy
+19%
High Cost Claimants
+600%
Ambulance
Office Visits
+33%
Type % of Expected HDHP 112% PPO 87%
Employee 47% Spouse 21%
Dependent 32%
Total Claimants
Employee 36% Spouse 51%
Dependent 13%
Add Spouse to Wellness Program Add $2 to EE+1 and Family Coverage Access to wellness portal & incentives
(fu (full ll-time)
Current Full-Time HDHP Rates
Tier Per Month EE Premium EE Only $96.50 EE+1 $287.31 EE+(2+) $418.82
Current Full-Time PPO Rates
Tier Per Month EE Premium EE Only $145.14 EE+1 $438.01 EE+(2+) $640.30 Renewal
2020 Full-Time HDHP Rates
Per EE Premium $ Change per Mo % Change $96.50 $0.00 0.0% $289.31 $2.00 0.7% $420.82 $2.00 0.5%
2020 Full-Time PPO Rates
Per EE Premium $ Change per Mo % Change $145.14 $0.00 0.0% $440.01 $2.00 0.5% $642.30 $2.00 0.3%
(p (part-time)
Current Part-time HDHP Rates
Tier Per Month EE Premium EE Only $188.00 EE+1 $475.51 EE+(2+) $694.71
Current Part-Time PPO Rates
Tier Per month EE Premium EE Only $285.29 EE+1 $726.69 EE+(2+) $1,063.84 Renewal
2020 Part-Time HDHP Rates
Per EE Premium $ Change per Mo % Change $188.00 $0.00 0.0% $477.51 $2.00 0.4% $696.71 $2.00 0.3%
2020 Part-Time PPO Rates
Per EE Premium $ Change per Mo % Change $285.29 $0.00 0.0% $728.69 $2.00 0.3% $1,065.84 $2.00 0.2%
(sin (since 201 2010)
0.00% 2.91% 0.00%
7.64% 13.91% 6.56% 3.50%
0.11%
0.00% 5.00% 10.00% 15.00% 20.00% 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Sin Since 2010
80.0 90.0 100.0 110.0 120.0 130.0 140.0 150.0 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
PPO family HDHP family PPO EE+1 HDHP EE+1 PPO EE HDHP EE Nat'l Avg
National Average = 4.9%
Step 1 Select Status Full-Time Step 2 Select Level of Coverage Employee Only Step 3 Select HSA Contribution Level 3 Step 4 # of Months of Coverage 12
If interested in looking at which option would work best for you and your family, contact Jason @ x6454 or Randi @ x6689
Per Mo Rate # of Months Total Per Mo Rate HSA Credit # of Months Total Premiums 145.14 $ 12 1,741.68 $ 96.50 $ 12 1,158.00 $ PPO HDHP Co-Pay's/Visit Expense
1
1
Out-of-Pocket Max Total 1,741.68 $ 1,158.00 $ $3,200 $3,200 EE HSA Contribution
12
43.50 $ 12 522.00 $ Mac HSA Contribution 143.50 $ 12 1,722.00 $ (564.00) $
Difference 2,305.68 $ Co-Pay's/Visit Expense 100.00 $ 1 100.00 $ 1,000.00 $ 1 1,000.00 $ Out-of-Pocket Max Total 1,841.68 $ 2,158.00 $ $3,200 $3,200
EE HSA Contribution
12
43.50 $ 12 522.00 $ Mac HSA Contribution 143.50 $ 12 1,722.00 $ 436.00 $
Difference 1,405.68 $
$0.00 $10 $49 $105 $161 $179 $348 $750
Average Expense Per Visit
Get Your Annual Visit & Cancer Screening
28.7% Preventative Care 22.8% Breast Cancer Screening 34.5% Cervical Cancer Screening 23.1% Colorectal Cancer Screening 60.6% Healthy Sleep
A primary care clinic that comes to you. Medical Visits Lab Tests X-ray/imaging Pharmacy (30 common medications)
6% of ER Visits 14% of Urgent Care Visits 49% of Clinic Visits 70% of Convenience Clinic Visits
Traditional clinics are not
Inconvenient: Wasted time in driving, waiting in room and visits that start late Ineffective: Rushed visits and limited availability leads to UC or ER…skipping care Not affordable: High cost of care, labs, x- rays and prescriptions
produce better outcomes
reduces high cost UC and ER use
saves time and money
adherence and saves time
patients time and keeps them healthier
Str Strep Throat
Vi Visit it Co Cost Ra Rapid id St Strep Tes est t Cos Cost Prescripti tion Co Cost Tot
Cost Travel and and Wait it Tim ime
Ni Nice Healthcare
$10 $0 $0 $0 0 Minutes
Minute Clinic
$99 $70 $10 $179 45 Minutes
Traditional Clinic
$75 $50 $10 $135 60 Minutes
Urgent Care
$150 $75 $10 $235 90 Minutes
Vi Visit it Co Cost A1 A1c c and and Gluc ucose Tes est Co Cost Tot
l Co Cost Travel and and Wai ait Tim Time
$10 $0 $0 0 Minutes
$129 $91 $220 45 Minutes
$150 $50 $200 90 Minutes
Diagnosis Prescriptions Referrals Wellness
Labs X-rays Prescription delivery Physical test
Chat, video, and home visits 80+ labs conducted in home Dispense and deliver 30+ Rx In home X-rays Referrals to specialists
Care that can’t wait 1-2 hours Emergency services Specialty care Vaccines Controlled substance prescriptions Women’s pelvic exams Men’s pelvic exams
Acute conditions treated:
moderate)
illnesses
strains
Chronic conditions managed:
High Cholesterol Hypothyroidism High Blood Pressure/Hypertension (non-emergent) Asthma (mild to moderate) COPD (mild) Diabetes Type 2 (non-insulin dependent, A1C <10) GERD Seasonal Allergies/Allergic Rhinitis Epi-Pen refills Eczema Acne (no Accutane) Depression (mild-moderate) Anxiety (mild-moderate/no controlled substances) Menopause Anemia (mild) Constipation Gout Osteoporosis (non IV or injectable treatments) Osteoarthritis Obesity Acute conditions typically referred:
urgent
Chronic conditions not managed:
1/Insulin Dependent
to severe)
substances
LAB NAME COMMON USE
Amylase Pancreas / salivary glands ANA autoimmune Basic Metabolic Panel (BMP) General Health Screening / Kidney / Electrolyte Complete Blood Count (CBC) General Health Screening / Anemia Complete Metabolic Panel (CMP) General Health Screening / Kidney / Liver / Electrolyte CPK Muscle test CRP Infection Ferritin Anemia test folate Anemia test Free T4 Thyroid test Gamma-glutamyl transferase (GGT) Liver Test Glucose General Health Screening / Diabetes Hemoglobin General Health Screening / Anemia Hemoglobin A1C General Health Screening / Diabetes Iron Anemia test Iron, total & IBC Blood iron test Lead Level Screening for children
LAB NAME COMMON USE
Lead Level Screening for children Lipase Liver / Pancreas Lipid Panel General Health Screening / High Cholesterol magnesium Electrolyte Mono spot Infection PSA Prostate screening Rapid Strep Infection RH factor Autoimmune Sed Rate (ESR) Inflammation marker Throat culture Infection TSH Thyroid test Uric Acid Gout test Urinalysis Infection Urine culture Infection Urine Microalbumin High Blood Pressure Urine pregnancy Pregnancy test Vitamin B12 General health / fatigue / anemia
PRESCRIPTION TYPE
Antibiotics Ear/Eye Drops Anti-Viral Anti-Fungal Skin Mental Health Diabetes Hypertension Thyroid Asthma Cholesterol Gastrointestinal Cold/Cough Sinus/Allergy
Online visits anywhere in the country Home and work visits in select MN counties Patient must be a MN resident to receive care outside of MN Any patient physically located in MN may receive care regardless of MN residency status
Allergies Bugs & Bites Cold, Cough & Flu Ear pain or infection Pink Eye or Stye Skin & Rashes (acne, cold sore, eczema, shingles,
chicken pox, rosacea, poison ivy, hives, athlete’s foot)
STI/Sexual Health Women’s Health (birth control & infections)
71% of participants can save Average savings of $50 to $110 per month Only 11% used the online pharmacy tool Get timely reminders and proactive communications on how to save
We all experience life changes and challenges from time to time. When you need some extra support, the Employee Assistance Program (EAP) is just a call or click away. These services are all confidential and available to you at no additional cost to you and your family members.
for your family
are well taken care of
loved one
No Change
Retirement Plan Time Off Benefits Flexible Spending Accounts Vision Insurance Identity Protection Long-Term Care Insurance 529 College Savings Plan DTAP Legal Plan
All FSA participants must re-enroll annually during open enrollment!
Kelly Fang Well-being Program Manager, Health & Wellness Coach
48% 48% 40% 22% 19% 47% 2017 2018 2019
HA completions in 2019
Activity completions Health assessments ≥ 1 Activity
Complete your health assessment Complete an activity of your choice Complete your annual preventive visit
Complete all three steps to earn a one month well-being premium discount valued at $96.50
(employee only monthly premium rate for the high deductible health plan)
Step 1 Step 2 Step 3
10 20 30 40 50 60
Low risk Moderate risk High risk Diagnosed
2016 2017/2018 2019 Goal
4%
Too few fruits & vegetables
Unhealthy stress or emotional health concerns
Keep your and Macalester’s insurance premiums low Reduce preventable healthcare expenses Challenge yourself or achieve better balance Increase Participation in the Wellness Program Help Macalester’s financial and cultural well- being And get rewarded for doing it!
Spouse/domestic partners now eligible! Quit smoking, eat better, move more, stress less, reduce back pain, lower blood pressure/cholesterol.
classes
weights, play Racquet ball, basketball or even ping pong.
membership for free.
Employee Only Health assessment Activity Activity $150 Visa Reward Card
Employee Spouse/Domestic Partner Health assessment Health assessment Activity Activity Activity Activity $300 Visa Reward Card
Step 1 Health Assessment
Complete before March 31 Get entered to win a free domestic airline ticket! Spouses eligible to win too!
(9/1/2019 – 8/31/20)
Sessions (In-person or Video)
Coach
Run/Walk
your Choice
Management Phone Coaching with a Nurse
Visit Benefits Portal @ Single Sign-on is enabled allowing for use of your regular Macalester login credentials Click on Start Your Enrollment Once complete with elections, check the I agree, and I’m finished with my enrollment box Click on Complete Enrollment to finalize your enrollment
Once your enrollment is complete, you may choose to view, email or print a confirmation statement By clicking on the home button, you will see the status of your enrollment as complete.
You have the option to make changes to your benefits if it is before 11/15/2019 by clicking Change my Elections on the home screen. Follow the prompts to make the necessary changes To confirm whether you have completed your benefit enrollment, log in the new benefit enrollment system located at . Once logged into your home landing page, a message in the upper left hand corner will say your enrollment is complete or Start Your Enrollment. After the open enrollment period closes on 11/15/2019, you will receive an email to prompt you to review your benefit enrollment. Benefit confirmation statements will not be mailed.
If your 01/01/2020 benefit statement does not reflect your intentions, you have until 11/20/2019 at 4:00 PM Contact to resolve discrepancies
* Jason Dempster at jdempste@macalester.edu or call 651-696-6454 * Randi Hartman at rhartman@macalester.edu or call 651-696-6689
No changes will be accepted after 11/20/2019.
Available at: macalester.edu/hr Online Open Enrollment Guide Link to Benefits Portal 2020 Open Enrollment Summary Detailed Individual Benefit Information
and obtain answers to your benefits questions
benefit vendors
Open Enrollment is November 1st through November 15th