NOVEMBER 1 15, 2019 Why? Promote benefits package that supports - - PowerPoint PPT Presentation

Why? ► Promote benefits package that supports work-life balance. ► Continue to emphasize the high-deductible plan choice. ► Maintain ACA compliance with coverage offer to 95% of employees.

Active Open Enrollment

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NOVEMBER 1 – 15, 2019

2014 2015 2016 2017 2018

• Est. 2019

Premiums vs. Claims $1,628,268

• $2,104,063
• $5,057,833
• $2,744,069
• $3,377,825

$850,454 UA Supplement + $2,000,000 + $1,200,000 + $2,000,000

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Health Plan Financial Status

$35,000,000 $40,000,000 $45,000,000 $50,000,000 $55,000,000 $60,000,000 2014 2015 2016 2017 2018 2019 Premiums Claims

9% Medical 8.5% Rx

INFLATION

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Health Plan Reserve Fund

$5,000,000 $7,000,000 $9,000,000 $11,000,000 $13,000,000 $15,000,000 2013 2014 2015 2016 2017 2018 2019 Reserve Fund Balance Recommended Reserve Target

As a self-funded health plan, UA assumes the financial risk of all claims incurred by employees &

• dependents. We use our reserve fund to collect premiums and pay claims. It is recommended to

maintain a funding level equal to 20% of annual claims expenses.

• $2.8m
• $5.4m
• $4.6m

$5.6m $6.8m $3.7m

• $0.5m

Vision Premiums

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Tier 2019 2020 Employee $5.74 $5.74 Employee + 1 $10.59 $10.59 Family $18.52 $18.52

Dental Premiums

Tier 2019 2020 Employee $28.09 $29.34 Employee + 1 $55.04 $57.49 Family $79.75 $83.31

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

ACTIVE ENROLLM LLMENT CONTINUES! Your current benefits will not roll over into the new year. You must ACTIVELY participate in Open Enrollment by logging in to BenefitFocus. Select your health, dental, vision coverage & flexible spending accounts, or …

NO CO COVERA VERAGE in 2020

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Teladoc is a telemedicine company that uses telephone and videoconferencing technology to provide 24/7 on-demand remote medical care for acute, non-emergency illnesses. The cost per Teladoc visit is $45.

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Teladoc

PPO HDHP Before Deductible $45 $45 After Deductible $20 $9

Teladoc.com/Alabama 1-855-477-4549

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

ABA is a new therapy benefit for children ages 0 - 18 with an Autism Spectrum Disorder diagnosis, subject to approval under BCBS medical policy guidelines. HB284 requires that all fully-insured, large group health plans in Alabama cover

• ABA. It is an optional benefit for self-funded plans like UA.

UA will offer this therapy benefit with a 20% coinsurance, subject to the first-dollar deductible and the following maximums per year:

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Applied Behavior Analysis (ABA)

Annual Maximums per Child Age Band Maximum 0 – 9 Years $20,000 10 – 13 Years $15,000 14 – 18 Years $10,000

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

Short-Term Disability pays 60% of your salary if you become temporarily disabled, meaning that you are not able to work for a short period of time due to illness/pregnancy

• r accident. UA will offer this post-tax, employee-paid benefit beginning January 1, 2020.
• Current Full-Time Employees: Elect this benefit during Open Enrollment. If you do

not enroll at this time, a late enrollment penalty will apply with a 60-day waiting period.

• New Full-Time Employees: 60 days to enroll after date of hire.

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Short Term Disability

Option 1 Option 2 Benefits Schedule 60% 60% Max Weekly Benefit $1,000 $1,000 Waiting Period 14 days 29 days Max Benefit Period 76 days 61 days

• Est. Premiums (age 0-54)

$18/mo $13/mo

Livongo is a voluntary health coaching program that enables people with diabetes to share blood glucose readings and

• ther health data with Certified Diabetes Educators.

Program participants will receive a free Welcome Kit with:

• Glucose meter, scale & blood pressure cuff
• Unlimited testing supplies via mail order delivery

Employees will not apply for Livongo program during Open

• Enrollment. Additional information will be available soon.

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Disease Management

Launching February 1, 2020

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

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Medical Deductible

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Rx Deductible

The first-dollar deductible will be a COMBINED $400 per person. A person can meet the deductible with medical or pharmacy claims, then the plan pays.

$400

$175, $175

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

PPO First-Dollar Deductible

$400 x 4

$175 x 4, $175 x 4

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PPO Out-of-Pocket Maximum

Tier 2019 2020 Employee $5,000 ($2,500 Med + $2,500 Rx) $5,000* Family without a Spouse $14,300 ($7,150 Med + $7,150 Rx) $14,300 Family with a Spouse $14,300 ($7,150 Med + $7,150 Rx) $14,300 *Individual Employee out-of-pocket maximum is built-in to the Family maximums. No one person can incur over $5,000 in medical or pharmacy costs per calendar year.

Once you or your family meets the out-of-pocket maximum, your healthcare is covered

100% for the rest of the year!

2019 2020

Monthly Employee UA Employee UA Employee Only $108 $448 $113 $469 Family without a Spouse* $386 $798 $396 $819 Family with a Spouse* $447 $798 $467 $834 Biweekly Employee UA Employee UA Employee Only $49.85 $206.77 $52.15 $216.46 Family without a Spouse* $178.15 $368.31 $182.77 $378.00 Family with a Spouse* $206.31 $368.31 $215.54 $384.92

*Both Family tiers can include Employee +1, 2, 3, etc., dependents.

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PPO Plan Premiums

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Flexible Spending Accounts

Account Healthcare FSA Dependent Care FSA

Annual Contribution Limit $2,700 $5,000 Minimum Contribution $125 $125 Eligible Expenses Pay for out-of-pocket healthcare expenses that are not covered by medical, dental or vision insurance for you and your tax dependents. Pay for childcare expenses for tax-dependent children under the age of 13. Funds Available Beginning of the year Funded per paycheck

• Pay expenses via debit card or manual reimbursement.
• Both accounts subject to use-it-or-lose-it rule. Incur expenses by December 31
• f the current plan year and submit for reimbursement by March 31 of the

following year or forfeit all remaining funds.

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If you do not enroll or re-enroll in benefits, then you will have

NO COVERAGE in 2020!

ACTIVE Open Enrollment begins November 1 – 15. Get a jump start and review your current benefits now!

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What is a High Deductible Health Plan (HDHP)?

Health Plan HDHP PPO

High Deductible Health Plan Preferred Provider Organization

Premiums

Lower Higher

Deductibles

Higher Lower

Member Cost Share (after deductible is met)

Coinsurance (20%) Copayments

Tax-Favored Accounts

Health Savings Account (HSA) Dependent Care FSA Healthcare FSA Dependent Care FSA

Third Party Administrator

Both plans are administered by Blue Cross & Blue Shield of Alabama.

Network Access

Both plans have the same network access and provider discounts.

Covered Services

Both plans have the same covered services.

Preventive Services

Both plans cover FREE preventive services at no cost share to the member.

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

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HDHP Out-of-Pocket Maximum

Tier 2019 2020

Employee $3,000 $3,500 Family without a Spouse $6,000 $7,000* Family with a Spouse $6,000 $7,000* *The Family tier out-of-pocket maximum is an aggregate amount. Any one person in a family can incur up to $7,000 in medical or pharmacy costs per year.

Once you or your family meets the out-of-pocket maximum, your healthcare is covered

100% for the rest of the year!

2019 2020

Monthly Employee UA Employee UA Employee Only $54 $385 $57 $406 Family without a Spouse* $193 $742 $198 $761 Family with a Spouse* $224 $753 $234 $787 Biweekly Employee UA Employee UA Employee Only $24.92 $177.69 $26.31 $187.38 Family without a Spouse* $89.08 $342.46 $91.38 $351.23 Family with a Spouse* $103.38 $347.54 $108.00 $363.23

* Both Family tiers can include Employee +1, 2, 3, etc., dependents.

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HDHP Plan Premiums

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

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By the Numbers – HDHP vs. PPO

Premium HDHP PPO Employee

$57 $113

Family without a Spouse

$198 $396

Family with a Spouse

$234 $467

First-Dollar Deductible HDHP PPO Employee

$1,400 $400

Family without a Spouse*

$2,800 per family $400 per person

Family with a Spouse*

$2,800 per family $400 per person

Out-of-Pocket Maximum HDHP PPO Employee

$3,500 $5,000

Family without a Spouse*

$7,000 $14,300

Family with a Spouse*

$7,000 $14,300

* The IRS treats any non-single contract as a family contract for deductibles and out-of-pocket maximums.

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Health Savings Account (HSA) vs. Healthcare FSA HSA is designed to be a “consumerism tool.”

It is a savings account owned by YOU, the employee. It is your money to manage!

HSA Healthcare FSA

Eligible Plan* HDHP PPO Account Type Savings Spending Ownership You! The Employee The University of Alabama Contribution Limits $3,550 Employee $7,100 Family $2,700 Funds Available Funded per paycheck Beginning of the year End of Year Balance Indefinite Carryover

Expenses must be incurred after HSA is open, but money can be reimbursed in later years.

“Use it or lose it” Rule

Expenses must be incurred within the plan year and reimbursed by March 31 of the following year.

Portability Y es No * Employees can be enrolled in any PPO plan and open an FSA or DCA account with UA. This does not apply to the HDHP – employees may only enroll in UA’s HSA if you also enroll in UA’s HDHP.

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Health Savings Account Benefits

• T

ax-favored savings account for “qualified medical expenses.” (IRS Pub. 502)

• Account is administered by T
• tal Administrative Services Corp. (TASC).
• Triple Tax Savings
• 1. Tax free payroll contributions from employee and The University.
• 2. Tax free distributions, when used for qualified medical expenses.
• 3. Tax free earnings accumulate, if invested.
• Retirement Savings Tool
• IRA-like investments, including mutual funds & interest-bearing accounts
• Age 55+ can contribute an additional $1,000 to HSA each year.
• After age 65, can no longer contribute to HSA if employee is enrolled in

Medicare, but can use HSA to pay Medicare premiums or long-term care.

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HSA Contributions

The University of Alabama will also contribute to your HSA. You must enroll and open your HSA account to receive this money! It is not automatic.

Tier UA “Seed Money” Contribution Employee Only $400 per year Family without a Spouse $800 per year Family with a Spouse $800 per year Account Employee Only Family* Annual Contribution Limit (Combined) $3,550 $7,100

* The IRS treats any non-single contract as a family contract for deductibles, out-of-pocket maximums, and contributions.

Unlike the FSA, you can change this monthly deduction throughout the year and contribute up to the following annual limits:

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

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In order to contribute to a Health Savings Account …

• You must be covered by UA’s qualifying HDHP.
• You cannot also be covered by a non-HDHP plan.

✓ Example: You cannot have other coverage on a spouse’s PPO plan. ✓ Example: You cannot be enrolled in Medicare.

• You cannot be listed as a dependent on another person’s tax return.
• You or your spouse cannot be enrolled in a healthcare FSA.
• You cannot use your HSA to pay for ineligible dependents.

✓ ACA allows children to remain on a parent’s plan until age 26. ✓ IRS considers child dependents up to age 18, or 24 if full-time student.

IRS Eligibility Rules for HSA

Disclaimer: This presentation is intended to serv e as a high-lev el benef its ov erv iew. It is not an exhaustiv e list of all requirements, limitations or exceptions related to insurance cov erages or tax-f av ored

• accounts. Employ ees are strongly encouraged to v isit hr.ua.edu/benef its/openenrollment f or additional inf ormation and more comprehensiv e resources.

UA will provide a premium discount to benefits-eligible active employees based on:

• 1. Family size, and
• 2. Total combined household income (1.5 x 2019 Federal Poverty Level).

To apply, employees must submit most recent Federal Income Tax Return, W-2s and 1099s. The discount is equal to UA’s single high deductible health plan premium = $57 per month. The premium assistance discount is applicable for both health plans, PPO or HDHP. Application Deadlines:

• Current Employees– Submit documentation during Open Enrollment (November 1 – 15).
• Newly Eligible Employees – 30 days from the effective date of enrollment in health plan.

Total Family Size Annual Household Income (1.5 x FPL) 1 $18,735 2 $25,365 3 $31,995 4 $38,625 5 $45,255 6 $51,885 7 $58,515 8 $65,145

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Premium Assistance Program

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Ac Active Op Open Enrollme ment

Novemb mber 1 – 15 15

If you do not enroll or re-enroll in health, dental and vision benefits or FSA and HSA accounts, then you and your dependents will have

NO COVER ERAGE E

January 1, 2020!

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Health Plan Comparison – Example 1

Disclaimer: This example is provided to highlight basic cost differences between the PPO and the HDHP and illustrate simple payment processes for medical and Rx claims incurred under either plan. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages. Facilities and providers have different billing processes, depending on their specific financial policies. Employees are strongly encouraged to contact Customer Service at BlueCross & BlueShield of Alabama with actual claims questions.

Linda has the flu and goes to the doctor in February.

Tier: Employee Only First-Dollar Deductible: Not met

Linda has the flu and goes to the doctor in February. Linda has employee only coverage. She has not met her first-dollar deductible yet.

PPO

• $100 BCBS eligible charge
• $35 Copay
• Doctor bills Linda $65 ($100 - $35)

✓ $ applied to deductible = $100 ✓ Remaining deductible = $300 ($400 - $100)

HDHP

• $100 BCBS eligible charge
• $0 Coinsurance
• Doctor bills Linda $100

✓ $ applied to deductible = $100 ✓ Remaining deductible = $1,300 ($1,400 - $100)

Example 1

Annual Premium = $1,356 ($113 x 12) Annual Premium = $684 ($57 x 12) + $400 seed

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Health Plan Comparison – Example 2

Disclaimer: This example is provided to highlight basic cost differences between the PPO and the HDHP and illustrate simple payment processes for medical and Rx claims incurred under either plan. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages. Facilities and providers have different billing processes, depending on their specific financial policies. Employees are strongly encouraged to contact Customer Service at BlueCross & BlueShield of Alabama with actual claims questions.

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Eric breaks his arm playing football and goes to the ER. Tier: Family with a Spouse First-Dollar Deductible: Met

Eric breaks his arm playing football and goes to the ER. Eric has family with a spouse coverage. He has met his first-dollar deductible.

PPO

• $1,500 BCBS eligible charge
• $150 Copay for facility
• Hospital bills Eric = $0

✓ $400 medical deductible met. ✓ $150 Copayment

HDHP

• $1,500 BCBS eligible charge
• $0 No Copay
• Hospital bills Eric = $300 or

20% coinsurance ($1,500 x 20%) ✓ $2,800 family deductible met. ✓ $300 Coinsurance

Example 2

Annual Premium = $5,604 ($467 x 12) Annual Premium = $2,808 ($234 x 12) + $800 seed

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Health Plan Comparison – Example 3

Disclaimer: This example is provided to highlight basic cost differences between the PPO and the HDHP and illustrate simple payment processes for medical and Rx claims incurred under either plan. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages. Facilities and providers have different billing processes, depending on their specific financial policies. Employees are strongly encouraged to contact Customer Service at BlueCross & BlueShield of Alabama with actual claims questions.

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Joanne has diabetes and a monthly Rx prescription for Humalog.

Tier: Employee Only First-Dollar Deductible: Not met

Joanne has diabetes and a monthly prescription for Humalog. Joanne has employee only coverage. She has not met her first-dollar deductible.

Example 3

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Premium = $1,356 ($113 x 12) Premium = $684 ($57 x 12) + $400 seed

PPO HDHP

Rx Cost $800 per prescription $800 per prescription 1st Rx Fill $400 deductible met + $45 copay

($400 deductible - $400 = $0 remaining)

$800 deductible + $0 coinsurance

($1,400 deductible - $800 = $600 remaining)

2nd Rx Fill $45 copay $600 deductible met + $40 coinsurance

($800 - $600 = $200 x 20% = $40 coinsurance)

3rd Rx Fill $45 copay $160 coinsurance

($800 x 20% = $160 coinsurance)

Health Plan Comparison – Example 4

Disclaimer: This example is provided to highlight basic cost differences between the PPO and the HDHP and illustrate simple payment processes for medical and Rx claims incurred under either plan. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages. Facilities and providers have different billing processes, depending on their specific financial policies. Employees are strongly encouraged to contact Customer Service at BlueCross & BlueShield of Alabama with actual claims questions.

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Scott is involved in a serious car wreck and is hospitalized.

Tier: Family without a Spouse First-Dollar Deductible: Not met

Scott is involved in a car wreck and is hospitalized. Scott has family without a spouse coverage. His family has not met any first-dollar deductibles.

PPO

• $10,000 BCBS eligible charge
• $400 Deductible
• $400 Copay for hospital admission
• Total Cost = $800

✓ Scott has now met his $400 individual deductible.

HDHP

• $10,000 BCBS eligible charge
• $2,800 Deductible
• $1,440 Coinsurance ($10,000 - $2,800

= $7,200 remaining x 20% = $1,440)

• Total Cost = $4,240

✓ Scott has now met his $2,800 family deductible.

Example 4

Annual Premium = $4,752 ($396 x 12) Annual Premium = $2,376 ($198 x 12) + $800 seed

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$7,000 OOP

ACTIVE OPEN ENROLLMENT

Novemb mber r 1 -15 15

If you only remember one thing from this presentation ….

You must enroll or re-enroll in benefits, otherwise you will have

NO COVERA ERAGE GE in 2020.

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1. Active Open Enrollment (November 1 – 15). No Action = No Coverage. 2. Visit the Open Enrollment website at www.hr.ua.edu/benefits/openenrollment. 3. Employees have a choice between the PPO and the HDHP with an HSA. This presentation provided a high-level review only. For more information, you can attend a detailed HDHP/HSA information session:

Key Takeaways

Date Location Times Topic September 11 North Lawn 1012 9:30 – 11:00 AM General September 19 North Lawn 2006 2:30 – 4:00 PM HDHP / HSA September 26 Employee Resource Center 5:30 – 7:00 PM General October 1 Employee Resource Center 5:30 – 7:00 PM HDHP / HSA October 7 Lloyd Hall 222 1:30 – 3:00 PM General October 15 North Lawn 2006 9:30 – 11:00 AM General October 23 Lloyd Hall 222 1:30 – 3:00 PM HDHP / HSA

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