Benefits Open Enrollment November 1 st through November 16 th Jason - - PowerPoint PPT Presentation
Benefits Open Enrollment November 1 st through November 16 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 Retirement Plan Wellness Program 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% Service/Feature PPO Delta Premier Out of Network Annual Max Benefit $1,500 $1,250 $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 max per child
Comprehensive Dental
Covered at 50% Covered at 50% Not Covered 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 Covered at 80% Covered at 50% Covered at 50% Covered at 75% Covered at 50% Covered at 50% Covered at 100% Covered at 100% Covered at 100%
Admin 0.0% 0.0% Type % of Expected Preventive 94% Comprehensive 92% Trend 3.5% 3.5% Total 98% 96%
Current Preventive Dental Rates
Per EE Premium
$4.64 $13.93 $21.71
Current Comprehensive Dental Rates
Per EE Premium
$26.66 $62.73 $100.48
Renewal
2019 Preventive Dental Rates
Per EE Premium $ Change per Mo % Change
$4.36
$13.10
$20.41
2019 Comprehensive Dental Rates
Per EE Premium $ Change per Mo % Change
$24.53
$57.71
$92.44
(sin (since 201 2013)
0.00% 0.00%
3.00% 26.61% 1.50%
0.00% 5.00% 10.00% 15.00% 20.00% 25.00% 30.00% 2013 2014 2015 2016 2017 2018 2019
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 (2019) PPO (2019)
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
Individual Employee+1 or Family
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
2019 Full-Time HSA Contributions
Max Matched Mac Contribution Annual Out-of-Pocket Maximum 2019 IRS Limits Max Amount for Unmatched Contribution Employee Only $2,244 $3,200 $3,500 $1,256 Family $4,488 $6,400 $7,000 $2,512
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
Max Matched Mac Contribution Annual Out-of-Pocket Maximum 2019 IRS Limits Max Amount for Unmatched Contribution Employee Only $1,482 $3,200 $3,500 $2,018 Family $2,964 $6,400 $7,000 $4,036
2019 Part-Time HSA Contributions
Inpatient Hospital Outpatient Hospital Pharmacy High Cost Claimants Ambulance Type % of Expected HDHP 77% PPO 86% Admin
Trend
Regression 3.12% 3.12% Reserve
(fu (full ll-time)
Current Full-Time HDHP Rates
Tier Per month EE Premium EE Only $112.93 EE+1 $340.08 EE+(2+) $496.65
Current Full-Time PPO Rates
Tier Per month EE Premium EE Only $165.08 EE+1 $501.72 EE+(2+) $734.23 Renewal
2019 Full-Time HDHP Rates
Per EE Premium $ Change per Mo % Change $96.50 ($16.43)
$287.31 ($52.77)
$418.82 ($77.82)
2019 Full-Time PPO Rates
Per EE Premium $ Change per Mo % Change $145.14 ($19.94)
$438.01 ($63.70)
$640.30 ($93.93)
(p (part-time)
Current Part-time HDHP Rates
Tier Per EE Premium EE Only $221.85 EE+1 $564.13 EE+(2+) $825.08
Current Part-Time PPO Rates
Tier Per EE Premium EE Only $326.17 EE+1 $833.53 EE+(2+) $1,221.06 Renewal
2019 Part-Time HDHP Rates
Per EE Premium $ Change per Mo % Change $188.00 ($33.86)
$475.51 ($88.62)
$694.71 ($130.37)
2019 Part-Time PPO Rates
Per EE Premium $ Change per Mo % Change $285.29 ($40.88)
$726.69 ($106.84)
$1,063.84 ($157.22)
(sin (since 201 2010)
0.00% 2.91% 0.00%
7.64% 13.91% 6.56% 3.50%
0.00% 5.00% 10.00% 15.00% 20.00% 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019
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
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 Difference 1,405.68 $
If interested in looking at which option would work best for you and your family, contact Jason @ x6454
$0.00 $49 $103 $161 $175 $300 $750
Average Expense Per Visit
Avoid Reactive Care Save Emergency Room for Emergencies Take Care of Yourself Practice Safety & Healthy Habits
$3,700 Minute Clinic $3,750 ER Visits $18,200 Urgent Care Visits $56,189 Primary Care Visits $680 Urgency Room Visits
497 Visits Savings
$82,519
Log onto healthpartners .com
Click on Start my visit in Online care Enter symptoms Nurse Practitioner diagnoses and creates treatment plan within 30 minutes Prescription sent to pharmacy of choice Pay for treatment. No more than $49 Feel Better!
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)
Ask About Generics Ask for a Discount Listen to Your Doctor Shop Around Try Mail-Order Medications Visit the Manufacturer’s Website
Macalester provides cost-free professional consultation and referral services for employees who are experiencing work and personal-related difficulties
Confidential consultation is provided including: Work relationships Conflict resolution Mental health Interpersonal relationships Family Loss and bereavement Alcohol/substance abuse Finding child or elder care Financial information, resources and tools Legal information, resources and consultations
All FSA participants must re-enroll annually during open enrollment!
Eligibility
2019 Monthly Premiums Coverage Premium Individual $8.95/mo. Family $16.95/mo.
3 Bureau Credit Monitoring
Alerts
Unlimited Consultation
Mobile App 24/7
Assistance
Comprehensive
Identity Restoration
Past
Current:
Goal of better renewal Leverage competition Sent requests to
vendors Markered
Cost Type Optional Life/AD&D Dependent Life Short-Term Disability Long-Term Disability Basic Life/AD&D % Change 0% 0% 19% 69% 33% Payor Employee Employee Employee Macalester Macalester
Reduce administrative requirements Streamline and simplify investment
Reduce Fees for participants and the plan Enhance the user experience
Combine Two Recordkeepers
TIAA
Reduced Fees
participants
Reduce Fund Options
Brokerage Window
“Best-in-Class” Fund Line-up
within fund class
Offer Mutual Fund Window
September 2018
begin
January 2019
November 2018
Sessions
counseling
December 2018
contributions sent to TIAA
corresponding fund type
January 2019
move to TIAA
corresponding fund type
No Action Required
funds wanted
a fund that is changing
Move to Calendar Year Health Assessment Feb-Oct New Wellness Portal & Platform Wellness Coach @ 4 Days Increase Incentives Increase Participation
Year Employee Macalester Collected Expense
2018 $4/mo $16/mo $127,920 $136,976 2019 $5/mo $20/mo $159,900
Kelly Fang Well-being Program Manager & Certified Wellness Coach
Statement of Purpose & Belief
56% 48% 48% 22% 22% 19% 2016 2017 2018
HA completions in 2018
Participants in 3-yr cohort
Program completions
Health assessments ≥ 1 Program
(Among Macalester employees who completed the health assessment)
AT RISK FOR DIABETES
NOT ADHERENT TO THEIR MEDS
OVER AGE 45 DID NOT SEE A PRIMARY CARE DOCTOR
OVERDUE FOR A COLONOSCOPY
OVERDUE FOR A MAMMOGRAM
Among all members, employees and spouses
Annual Health Assessment Annual Preventive Care Visit Disease & Case Management Phone Coaching NEW Choose to Lose online program NEW Well-being Challenges
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Additional resources
Talk with a nurse
Support 24/7, 365 days a year at no cost to you. Learn more
Healthy Living blog
The latest health trends and advice from our healthy living experts. Learn more
Helpful links
Custom link 1 Custom link 2 Custom link 3 Custom link 4 Custom link 5
Activity options Reward information
58
Step 1
59
60
Step 1
more! Step 2
12
Online/Mobile
WHAM 6-week Class Health Coaching NEW: Sugar Shake-Up Challenge (Jul. ‘19) NEW Path: Paths to Positivity (Oct. ‘18) NEW: Lose Weight in 8 Challenge (Feb. ’19) 10,000 Steps NEW Choose to Lose NEW Healthy Thinking Disease and Case Management (DCM) Phone Coaching Stress Tracker Sleep Tracker NEW Go for Fruits & Veggies Beating the Blues
The more activities you complete the more chances you have to win!
(employee only monthly premium rate for the high deductible health plan)
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Step 1
Step 2 Step 3
*Only preventive care visits completed between September 1, 2018 and August 31, 2019 will qualify, to allow time for processing. No tracking or forms are required on your part! Well-being premium holidays will be awarded in April, July, September & December 2019.
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Complete your annual preventive visit* Step 3
Visit macalester.bswift.com
Username: Mac Username (first part of email address), Password: Previously established personal password
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 11/16/2018 by clicking Change by 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 macalester.bswift.com. 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 11/16/2018, you will receive an email to prompt you to review your benefit enrollment. Benefit confirmation statements will not be mailed.
If your 01/01/2019 benefit statement does not reflect your intentions, you have until 11/21/2018 at 4:00 PM To contact Jason Dempster at jdempste@macalester.edu or call 651-696-6454 to resolve any discrepancies.
No changes will be accepted after 11/21/2018.
Available at: macalester.edu/hr Online Open Enrollment Guide Link to online benefit enrollment system 2019 Open Enrollment Summary Detailed Individual Benefit Information
and obtain answers to your benefits questions
benefit vendors
Open Enrollment is November 1st through November 16th