Welcome Catholic Diocese 2018 Open Enrollment
Agenda Open Enrollment Health Plan –Wellmark Blue Cross Blue Shield Health Savings Account (HSA) – Vision Plan Next Steps
How to Enroll Review your current benefits election All benefit eligible employees will complete a benefit election form. Once you make benefit elections, you will not be able to change them until the next open enrollment period unless you have a qualified change of status
2018 Medical Benefits
Health Plan Self-funded plan renewing with Wellmark Blue Cross Blue Shield Preferred provider organization network – Iowa and South Dakota: Blue Select – Nationwide: Blue Card – Find a participating provider at www.wellmark.com Out-of-network providers have a higher deductible and coinsurance
Online Access My Wellmark – www.wellmark.com – Register with your ID card – Track and organize your medical claims and expenses – Find a trusted health provider – View the Wellmark drug list – Get health news, resources and tips – Sign up to receive your health statements online
Additional Benefits Personal Health Assistant 24/7 – Nurse hotline – Phone number on the back of your ID card Blue365 – Discounts on a variety of items/services MyIDCare – Monitor your credit record – Track your online activity 24/7 – Access to complete identity recovery
How Can You Become a Good Consumer? Get preventive screenings – By having an annual exam, you can help avoid a catastrophic or large claim in the future Share the formulary list with your provider – Ask for a generic drug versus a brand name drug – Ask for samples/discount coupons from your doctor – Review the Wellmark drug list (Blue Rx Value Plus) on www.wellmark.com – GoodRx: mobile app and internet site to assist you with price shopping for your prescriptions https://plus.google.com/+Goodrx1/posts
myWellmark Care Finder Know cost of care − Compare the costs of medical procedures and know what your out-of-pocket costs will be Know quality of care − Members review and rate their healthcare providers Know where to get care − Locate doctors and hospital
Doctors on Demand – Medical Care Treating minor medical conditions – Colds, flu and sore throat – Bronchitis and sinus infections – Urinary tract infections – Skin and eye issues – Allergies – Diarrhea and vomiting – Sports injuries Cost – Traditional and Bronze Plan: $10 copay – High Deductible Health Plan (HDHP): $49
Doctors on Demand – Mental Health Mental and behavioral health support – Anxiety, stress, worry – Depression, grief – Relationship issues – Smoking or alcohol cessation – Body image/eating disorder Cost – Traditional Plan: $10 copay – HDHP: $65 to $110 depending on length of visit
Generic Preventive Rx Select generic preventive prescriptions will be paid at 100% after a $10 copay under HDHP Treatment for conditions like high blood pressure, high cholesterol, diabetes, depression, cardiac and respiratory conditions Visit wellmark.com to review the Wellmark drug list – PV next to the drug name indicates the medications that are included in the benefit This drug list is updated periodically
2018 Plan Design Overview High-Deductible Health Covered Services Plan (HDHP)/HSA Traditional Health Plan Bronze Health Plan Qualified $2,500 single $1,000 single $2,000 single Deductible – calendar year $5,000 family (aggregate) $2,500 family $4,000 family Coinsurance 0% 20% 50% Out of pocket – calendar year $2,500 single $3,500 single $6,350 single (includes deductible, coinsurance $5,000 family $8,750 family $12,700 family and copay) (any combination) Office visit services • Primary care physician 0% after deductible $25 copay $50 copay • Specialist care 0% after deductible $50 copay 50% coinsurance • Doctors on Demand $49- $110 $10 copay $10 copay Wellness services – routine exams, 100% paid; deductible 100% paid; deductible 100% paid – deductible women’s preventive health, waived; no patient cost waived; no patient cost waived; no patient cost colonoscopies, etc. sharing sharing sharing Prescription drug coverage • Deductible $10 copay on Preventive $100 single; $200 family $100 single; $200 family • Generic RX, deductible waived $12 copay (ded waived) $0 copay (ded waived) • Formulary $35 copay $25 copay • Non-formulary All other RX 0% after $50 copay $100 or $200 copay • Out-of-pocket maximum deductible $1,000/$2,000 NA $750 single Employer dollars to HSA None None $1,500 family
Health Savings Account (HSA)
HSA Quiz – True or False 1. I’m only enrolled in Medicare Part A, so I can still enroll in an HSA. False – if you are enrolled in Medicare Part A, B or Tricare, then you cannot contribute to an HSA 2. My husband has a traditional plan with single coverage through his employer, so I can still open an HSA. True – the IRS only prevents you, the account holder, from having first-dollar coverage and an HSA 3. My husband has a medical flexible spending account (FSA) through his employer but I don’t have an FSA through mine, so I can open and contribute to an HSA. False – your family unit can not participate in an FSA, HRA and HSA
HSA Quiz – True or False 4. HSAs allow you to pay medical bills with tax- free money. True Money goes into your account on a pre-tax basis Withdrawals for qualified medical expenses are tax free Balances in the account grow interest, tax free This is called the “triple tax advantage”
HSA Quiz – True or False 5. I can only use my HSA dollars to pay expenses for dependents covered under my health plan. False – you can use your HSA dollars to pay for yourself, your spouse and your tax-dependent children even if they are not covered under my HDHP 6. I can use my HSA dollars for non-medical expenses after I turn 65 and not be subject to the 20% penalty. True – If you use your HSA dollars for non-eligible expenses prior to age 65, you are subject to a 20% penalty and appropriate taxes. Once you hit age 65, you can use the HSA dollars for non-eligible expenses and only pay the appropriate taxes like an IRA. Eligible expenses are still tax free.
HSA Quiz – True or False 7. The IRS sets the annual HSA contribution limits. In 2018, the HSA contribution for single coverage is $3,450 and family coverage is $6,900. This annual maximum includes all contributions made into the HSA, including the employer contribution. True – the annual maximum includes all contributions into your HSA 8. Once I turn 55, I can contribute an additional $1,000 into my HSA annually. True – HSA account holders can contribution a “catch-up” contribution of $1,000 annually
Record Keeping Whenever you use HSA funds to pay for a medical expense, you should keep your receipt You may need to demonstrate to the IRS that HSA distributions were for qualified medical expenses If the IRS requests receipts for verification purposes, failure to provide those receipts could result in having to pay a penalty
HSA Vendor HSA through Discovery Benefits www.discoverybenefits.com Debit card and online reimbursement requests Cash account – Funds default to the cash account Higher interest bearing account – Automatic transfer (48-hour turnaround) Mutual funds – Automatic transfer (three- to five-day turnaround) Address updates should be made on your DBI portal You can set HSA to automatically transfer funds to the higher interest account or mutual funds through DBI portal
Vision Coverage
Vision Benefit If you elect medical coverage you will receive the vison benefit through VSP Exam – 100% once every 12 months Glasses – 20% discount You will not receive a VSP ID card. You just need to give your provide your social security number and they will be able to access your eligibility information in the VSP system.
VSP - Value Adds Discounts on prescriptions, telemedicine, hearing aids and more TruHearing – save up to 60% on brand-name hearing aids. Visit truhearing.com/vsp or call 877.396.7194 for additional information. 12 month warranty on select glasses purchased by Premier Program providers. Visit VSP.com for additional information
Next Steps
What to Do Next All employees must complete the 2018 Benefit Election Form. If you are changing any of your current elections a new enrollment form must be completed. All plan descriptions and forms can be found on the diocesan website at www.sfcatholic.org/human- resources. Watch the mail for your new Wellmark ID Card in December.
Dates to Remember Open enrollment period October 10, 2017 to October 31, 2017 Return all paperwork to your local benefit coordinator
Please Note… This benefit summary is intended only to provide you with a brief overview of your benefits It is not a contract and should not be relied upon to fully determine your coverage Refer to your summary plan description for an exact description of the services/supplies that are covered, exclusions and other conditions of coverage
Questions? Thank you!
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