Employee Benefits Open Enrollment 2015 Agenda Employee Benefits - - PowerPoint PPT Presentation

Employee Benefits Open Enrollment 2015

1

Agenda

• Employee Benefits Update
• 2015 Medical Plans
• 2015 Ancillary Benefit Plans
• Additional Benefits
• Next Steps

2

Healthcare Cost Management

What is exp doing to help manage rising healthcare costs?

• Exp has designed a program that provides a

comprehensive level of benefits that promotes wellness and offers choice to our employees

• Exp currently pays a large portion of health care

coverage premiums for eligible employees and dependents

• Exp offers tools and incentives to empower members to

be responsible healthcare consumers

3

Changes in 2015

Changes in Benefits for 2015

• Exp is switching insurance carriers for dental, vision, life

and disability

• Guardian will be the new carrier for 2015
• The dental plans have the same plan designs and

contributions, but will be with Guardian

• The vision plan will use the Davis network. The plan

will be similar, and you will see a small reduction in premium

• Life and disability insurance will also be administered

by Guardian

What Can You Do?

• Become better healthcare consumers
• Be proactive with your health – get your annual exams

and preventive screenings

• Go to your doctor or a convenience care clinic when ill;

don’t wait

• Complete an online Health Risk Assessment
• Use urgent care for non-emergencies instead of the

emergency room

• Use generic medications when possible
• Follow Rx dosage instructions

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5

2015 Benefit Overview

Carrier Coverage

UnitedHealthcare Medical, Prescription Drugs Guardian Dental, Vision, Life and AD&D, Short- term and Long-term Disability Trustmark Accident and Critical Illness Plans Allstate Cancer Plans myCafeteriaPlan Flexible Spending Accounts and Health Reimbursement Accounts Health Advocate Assists employees and families navigate the healthcare system Guardian Employee Assistance Program

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Medical Plan

• All of the plans will remain the same for 2015.
• UnitedHealthcare will continue to be the national insurance carrier for

exp, with the exception of employees in Alaska.

• You will have 3 options to choose from:
• The Choice Plan offers in-network benefits with co-pays at the

physician’s office and pharmacy.

• The Choice Plus Plan offers in and out-of-network benefits with co-

pays at the physician’s office and pharmacy.

• The HRA Plan is a high deductible in-network only health plan that
• ffers a Health Reimbursement Account.
• Preventive is covered at 100% with no co-pays on all plans.

UnitedHealthcare Medical Options

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CHOICE PLAN

• Primary Care/Specialist office visit:

$15/$40

• In-patient hospital care:

20% after deductible

• Out-patient hospital care:

20% after deductible

• Emergency room:

$250 (any ER)

• Urgent Care:

$75

• Lab and x-ray:

Covered in full

• Scans and Therapies

20% after deductible

• Deductible (Individual/Family)

$750/$1,500 per year

• Out-of-Pocket (includes deductible)

$3,750/$7,500 per year

• Lifetime Maximum

Unlimited

• Prescription Drugs (Retail)

$10 Tier 1/$35 Tier 2/$70 Tier 3

• Mail Order (90 day supply)

2.5x Retail

TYPE OF SERVICE YOU PAY:

CHOICE PLUS PLAN

• Primary Care/Specialist office visit: $15/$40
• In-patient hospital care

20% after deductible

• Out-patient hospital care

20% after deductible

• Emergency room

$250 (any ER)

• Urgent Care

$75

• Lab and x-ray

100% covered

• Scans and Therapies

20% after deductible

• Deductible (Individual/Family)

$500/$1,000 in-network; $2,000/$4,000 out-of-network

• Out-of-Pocket (includes deductible)

$3,500/$7,000 in-network; $5,000/$10,000 out-of-network

• Lifetime Maximum

Unlimited

• Prescription Drug(Retail)

$10 Tier 1/$35 Tier 2/$70 Tier 3

• Mail Order (90 day supply)

2.5x Retail

• Out of network coinsurance

40% after deductible

TYPE OF SERVICE YOU PAY:

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CHOICE HRA PLAN

• Primary Care/Specialist office visit:

$25/$50

• In-patient hospital care:

20% after deductible

• Out-patient hospital care:

20% after deductible

• Emergency room:

$250(any ER)

• Urgent Care:

$75

• Lab and x-ray:

Covered in full

• Scans and Therapies:

20% after deductible

• Deductible (Individual/Family)

$2,000/$4,000

• Out-of-Pocket Maximum (includes deductible)

$4,500/$9,000

• Lifetime Maximum

Unlimited

• Prescription Drugs (Retail)

$10 Tier 1/$35 Tier/ $70 Tier 3

• Mail Order (90 day supply)

2.5x Retail

TYPE OF SERVICE YOU PAY:

Health Reimbursement Account

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• Exp is offering employees a Health Reimbursement Account (HRA) on the high deductible

plan option only to help offset the costs associated with out of pocket expenses.

• The company will be adding an annual contribution of $500 automatically to your HRA on

January 1. You can use this money for co-pays, deductibles, or other out of pocket costs associated with qualified medical, dental, or vision expenses. You will receive a debit card to access the money.

• You are able to earn an additional $500 one time contribution into your HRA fund. Each

employee that completes an on-line Health Risk Assessment will be eligible for an additional $500 contribution to the HRA.

• Spouses and dependents can use Health Reimbursement Account (HRA) funds only if they

are enrolled in a health plan that meets the minimum standards of the ACA (either with exp

• r elsewhere). Spouses and dependents with no proper health insurance coverage will not

qualify for HRA use.

• HRA funds do not roll-over into next plan year. Unused HRA funds will be forfeited at the

end of the plan year.

• If you elect the Healthcare FSA also, your HRA funds will be used first.

Health Risk Assessment

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• A Health Risk Assessment provides you

with an individual wellness score that measures your overall health, will take about 20 minutes to complete, and includes 50 standard lifestyle questions.

• The Assessment is confidential, and you
• nly need to complete the Assessment,

not achieve a certain score.

• To start the Health Risk Assessment, you

will need to set up an account at www.myuhc.com. w.myuhc.com

• No need to submit proof upon completion,

balances to the HRA will automatically be credited the additional $500 on a monthly basis.

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Scans and Therapies

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• Scans and Therapies are major diagnostic services such

as MRI, CT Scan, PET Scan, MRA and Nuclear Medicine.

• They are typically performed at a hospital or out-patient

center, and sometimes in a doctor’s office.

• They can cost several hundred dollars or more (if in-

network, more if out-of-network.)

• Use the Treatment Cost Estimator on myUHC.com to

determine what your cost will be.

• Regardless of where the test is done, the benefits are

subject to Deductible, then Coinsurance, even if performed in a doctor’s office (“Covered” does not mean “Paid at 100%.”)

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Saving money on Prescriptions

• Several pharmacies now offer special prescription programs,

including $4 generic drugs and free antibiotics.

• Generic drugs contain the same active ingredients and are

available in the same strength and dosage form as their brand- name counterparts but could cost up to 50% less. Generic Medications:

• You can order a 3 month supply of medicine to be shipped to you for
• nly the cost of 2.5 co-pays.
• This saves you time and money for medicines you take on a routine

basis. Mail Order Prescription Benefits:

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myUHC.com

• Look up network doctors /

hospitals

• Estimate costs
• Track claims status
• Health improvement

program

• Personal Health Record
• Health product discounts
• Review plan details

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You will be assigned a Personal Health Advocate (PHA)

Health Coaching

• Obtain unbiased health

information

• Help prepare patients for

healthcare appointments

• Help members become active

participants in their healthcare Information & Service Support

• Assist with eldercare issues
• Obtain health information to help make

informed decisions

• Assist with finding qualified wellness

programs

• Help arrange transportation

Clinical Services

• Find qualified healthcare providers
• Schedule appointments
• Locate and research the newest

treatments

• Assist with complex medical condition
• Assist with understanding test results

Administrative Services

• Navigate within an insurance

company

• Assist with correcting billing

mistakes

Health Advocate

• 24/7 Toll-free telephone support
• Your privacy is protected

Dental Benefits

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• Guardian is the provider for dental insurance.
• There are 2 plans to choose from: a low and a high PPO option.
• Please visit www.guardiananytime.com to look up dentists in the

network.

Dental Insurance - Guardian Life Insurance Company

Benefit Details Low Plan You Pay: High Plan You Pay: Preventive & Diagnostic Services Deductible waived for preventative Deductible waived for preventative In-Network Covered in Full, no deductible Covered in Full, no deductible Out-of-Network Covered in Full @ R&C*; no deductible Covered in Full @ R&C*; no deductible Basic Services In-Network 20% after deductible 20% after deductible Out-of-Network 20% after deductible** 20% after deductible** Major Services In-Network 50% after deductible 50% after deductible Out-of-Network 50% after deductible** 50% after deductible** Orthodontic Services In-Network & Out-of-Network 50% to $1,500 lifetime max, No Deductible Dependent Child Only up to age 19 50% to $1,500 lifetime max, No Deductible Dependent Child Only up to age 19 Calendar Year Deductible Individual / Family Individual / Family In-Network $50/$150 $50/$150 Out-of-Network $50/$150 $50/$150 Annual Maximum Benefit In-Network & Out-of-Network $1,000 Combined $2,000 Combined

** Important: When using an out-of-network provider, you may be balanced billed for amounts over the reasonable and customary charges *R&C = Reasonable and Customary: the amount that your health plan determines is the normal range of payment for a specific service within a given geographic area

Vision Benefits

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• Guardian is the provider for vision insurance, using the Davis Vision network.
• Please visit www.davisvision.com to look up a provider in the network.

Vision Insurance - Guardian Life Insurance Company

Benefit Details Choice Plan You Pay: Benefit Frequency Exams Once every 12 months Lenses Once every 12 months Frames Once every 24 months Exam Co-pays In-Network $10 Co-pay Out-of-Network Up to $50 Allowance Lenses Co-pay Single Vision: In-Network $25 Co-pay Out-of-Network Up to $48 Allowance Bifocal: In-Network $25 Co-pay Out-of-Network Up to $67 Allowance Trifocal: In-Network $25 Co-pay Out-of-Network Up to $86 Allowance Lenticular: In-Network $25 Co-pay Out-of-Network Up to $86 Allowance Frames In-Network $130 Allowance Out-of-Network Up to $48 Allowance Contact Lenses Conventional: In-Network Up to $130 Allowance Out-of-Network Up to $105 Allowance Medically Necessary: In-Network $25 Co-pay Out-of-Network Up to $210 Allowance

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• Exp provides all full-time employees with Basic Term Life Insurance

with Accidental Death & Dismemberment (AD&D.)

• The benefit amount is two times your annual earnings to a maximum
• f $200,000.

Employee Life and AD&D Insurance

Supplemental Employee Coverage

• AD&D Coverage included at no additional cost.
• Elect coverage in units of $10,000.
• Maximum is the lesser of $500,000 or 5 times basic annual earnings.
• Guarantee Issue amount is the lesser of 3 times basic annual earnings or

$150,000.

• If you have never enrolled in this benefit, this year you may purchase up to

the guaranteed issue amount without submitting evidence of insurability

• forms. If you do not elect Voluntary Insurance during this Open Enrollment

but choose to elect at a later time, you will need to complete the appropriate forms and be approved for this benefit.

• If you have Voluntary Life with United Healthcare already, your coverage

will rollover with Guardian and no action is needed unless you elect more coverage than the guaranteed issue. If you elect more coverage, you will be prompted to complete an evidence of insurability form.

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Dependent Life Insurance

Supplemental Spouse Coverage

• If you elect Employee Supplemental Life and AD&D Insurance for yourself,

you may choose to purchase Spouse Supplemental Life and AD&D Insurance in increments of $5,000, $5,000 minimum to a maximum of $100,000.

• You may only elect up to 50% of the employee’s election for spouse life
• insurance. For example, if you elect 100k on yourself, you can only elect up

to 50k on your spouse.

• Spouse rate are based on Employee's age bracket.
• You may purchase up to the guaranteed issue amount this year without

having to fill out evidence of insurability forms.

Children Coverage

• If you elect Supplemental Life and AD&D Insurance for yourself, you may

choose to purchase Child(ren) Supplemental Life and AD&D Insurance in increments of $2,000, $2,000 minimum to a maximum of $10,000 for each child.

• Eligible Child(ren) are from age 15 days to 26 years.

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Disability Insurance

• In the event you are out of work due to a short term medical

condition, exp provides all eligible employees a Short-Term Disability program through Guardian.

• This benefit will pay up to 60% of your weekly earnings to up

to a maximum amount for up to 13 weeks.

• The company also provides Long-Term Disability at no cost

to the employees.

• This benefit will covers you at 60% of your basic monthly

earnings up to a maximum should you be unable to work due to non-work related illness or injury.

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Voluntary Benefits

• Voluntary benefits provide you with supplemental coverages

that strengthen your overall benefits package.

• The Trustmark Critical Illness Insurance is a benefit that will

pay you a lump sum of money if you are diagnosed with a critical illness, heart attack or stroke.

• The Trustmark Accident insurance is a plan that helps pay

for the unexpected expenses that result from an accident.

• The Allstate Cancer Insurance offers a first occurrence

benefits that pay cash to you based upon the severity of the cancer diagnosis

• See the state specific brochure from Allstate and Trustmark

for additional details and rates

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Flexible Spending Account

• The FSA allows you to put money aside through payroll

deductions before taxes are withheld to pay the cost of health care expenses not covered by your medical plan and for the cost

• f qualified dependent care.
• By doing so, you reduce your taxable income, which increases

your take-home pay.

• Healthcare FSA – allows you pay for certain IRS-approved medical

care expenses not covered under your insurance plan with pre-tax dollars.

• Please note that the new IRS limit to this account is $2,550

annually.

• Dependent Care FSA – allows you use pre-tax dollars towards

qualified dependent care expenses.

• Adoption Assistance FSA – provides tax break for adoption

expenses.

• Qualified Transportation Plan – allows you to set aside pre-tax

funds to be used for transportation and commuter parking expenses for travel to and from work.

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Important Information for Flexible Spending Accounts

• You must make an election to enroll in the 2015 FSA programs, as this

benefit will not roll over into the new plan year.

• If you have any HealthCare FSA funds from 2014 left over, you may roll

up to $500 into the new plan year. This will automatically occur for you, no action is needed on your end. Please check your 2014 balance on www.mycafeteriaplan.com www.mycafeteriaplan.com.

• For 2014 Healthcare FSA participants: You will have until March 31,

2015 to submit for reimbursement for FSA Health expenses incurred during the plan year from January 1, 2014 to December 31, 2014. There is no longer a grace period for incurring claims in 2015, because the plan will allow up to $500 of unused funds to roll over into the 2015 plan year.

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MyCafeteriaPlan.com

• My Cafeteria Plan manages the FSA/ HRA accounts
• You will receive a “Benny Card” in the mail soon after

January 1st. If you are already enrolled, you will keep the same debit card that you have and money will be added to this card for the new plan year.

• You may go online to check your balances and account

activity at http://myaccount.mycafeteriaplan.com

• Please see Christie New for assistance or with questions.

Christie can be reached +1.407.660.0088 x 252 or by email at christie.new@exp.com.

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Enrollment Process

• This year you will be enrolling via a self-service online enrollment

system, EMB Enroll. The online system can be accessed from any computer with internet access.

• If you are making changes to your current benefits, you will need to

log onto the EMB Enroll site and complete the process. If you do not enroll, your current benefits will roll over into a similar plan with Guardian for 2015.

• Any amounts up to $500 in your 2014 Healthcare FSA will roll over

into 2015. If you want to enroll into the 2015 FSA, you will need to make an election. Your 2014 Election amounts will not rollover. If you don't make an election you will have a zero election amount.

• Please see your enrollment guide for the instructions on how to log in

and use the online enrollment system to complete your enrollment.

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Next Steps

• Please review your benefit guide and carrier summaries.
• Please make sure to have the necessary dependent information

(birth date, social security numbers) if you are enrolling dependents to any of the plans for the first time.

• Select your benefits carefully. The only changes that can be made

mid-year are for life events such as marriage, divorce, birth or adoption, death, or a reduction in hours from full-time to part-time.

• Notify Human Resources within 30 days of having a life event in
• rder to make any changes.
• Should you have any questions, do not hesitate to contact exp’s

Benefits Analyst, Christie New, at +1.407.660.0088 x 252 or by email at christie.new@exp.com.