1 hebrew union college 2011 benefits presentation presented by: trista owens, usi midwest
TRANSCRIPT
1
Hebrew Union College 2011 Benefits Presentation
Presented By:
Trista Owens, USI Midwest
2
Meeting Overview
Medical InsuranceHealth Care Reform changesBase PPO PlanBuy Up PPO PlanLumenos H.S.A. PlanGood News! No change to Employee Contributions
Dental Insurance-Plan DesignEmployee Contributions
Life/AD&D and Long Term Disability- No Changes
Flexible Spending Account
Open Enrollment Procedures and Deadlines
3
Health Care Reform
Changes that will go into place at renewal-
No lifetime maximum (current $5,000,000) or unreasonable annual limits on essential benefits
Dependents are now eligible for health insurance up to age 26
Preventive care on all plans will be covered at 100% with no copay or deductible (H.S.A. plan currently already has this coverage)
4
Base PPO Plan
In Network- Anthem National Blue Card NetworkCalendar Year Benefits Deductible- Single $1,000; Family $2,000 Coinsurance- 80% Anthem; 20% MemberOut of Pocket Maximum- Single: $3,000; Family $6,000Office Visit Copay- $25 copayEmergency Room- $100 copayUrgent Care- $50 copayPrescription Drugs- $100 deductible per person per calendar year then $10 Tier 1; $30 Tier 2; $50 Tier 3Lifetime Maximum- Unlimited
This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
5
Buy Up PPO Plan
In Network- Anthem National Blue Card Network
Calendar Year Benefits
Deductible- None
Coinsurance- 90% Anthem; 10% Member
Out of Pocket Maximum- Single: $1,000; Family $2,000
Office Visit Copay- $20 copay
Emergency Room- $50 copay
Urgent Care- $35 copay
Prescription Drugs- $10 Tier 1; $25 Tier 2; $45 Tier 3
Lifetime Maximum- Unlimited
This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
Lumenos H.S.A. Plan Overview
7
Your Lumenos In Network H.S.A.Plan Details At-a-Glance
Lumenos Plan Single Coverage Family Coverage
Preventive Nationally recommended servicesNo cost, no deduction from HSA with in-
network providers
Traditional Health Coverage
Annual Calendar Year Deductible-
You will be given credit for any deductible met from 1/1/11 through
6/30/11 (if you are currently in the Base PPO plan)
$3,000$6,000 Non-Embedded
Medical Services
Prescription Copays after the deductible is met
100% for In-Network Services
Tier 1: $10; Tier 2: $30; Tier 3 $50; Tier 4: 25%
HSA
You can use the funds from your Health Savings
Account to help satisfy your annual
deducible
Employer’s 1st Year allocation (Half will be funded 7/1/11 and the other half
1/1/12)
Annual IRS HSA contribution maximum combined between the
employer and the employee
$1,000
$3,050
$2,000
$6,150
This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and
eligibility.
How Does the Lumenos Plan Work?
9
Lumenos Plan with an HSA
With the Lumenos plan, you have a high deductible medical plan coupled with a Health Savings Account (HSA)
• You can fund your HSA with pre-tax payroll contributions or post-tax contributions (which are deductible when you file your taxes)
• The money in your HSA can be used to pay for your medical care, including prescriptions that go towardsatisfying your deductible
• Once you’ve satisfied your deductible the plan’s Traditional Health Coverage prescription copays kicks in.
10
Using Your Lumenos Plan to Get CareWhen you visit an in-network doctor:
Show your ID card at the time of serviceTypically you pay nothing at the time of service.
Your provider will file a claimYou will receive a Claim Recap showing the total cost
and the “allowed” cost. Your provider will then bill you for the “allowed” cost of the service(s)
If you have funds in your HSA you can pay your provider using your HSA checkbook or debit card
When you visit a doctor that is not in the network:Show your ID card at the time of serviceYou may be asked to pay at the time of services.Use your HSA checkbook or debit card to pay your
provider for services (provided you have the funds available)
If your provider does not file a claim on your behalf, you will need to file a claim with Anthem BCBS to ensure expenses get applied towards your out-of-pocket. You can download a claim form at anthem.com
11
Using Your HSA Plan to Get Care
When you visit a pharmacy:Show your ID card at the pharmacy
Until you have satisfied your annual deductible you will pay the full discounted cost of your prescription drug
You can pay for your prescription at the pharmacy using your HSA debit card or checkbook as long as there are funds available in your HSA account.
After the deductible is met you will pay the applicable copays of $10/$30/$50/25%.
Using your HSA for Qualified Medical Expenses
13
Can I Use My HSA to Pay for Non-Qualified Medical Expenses?
Yes, but…Any amount you spend will be considered taxable income (you
will have to pay taxes on the amount used), and you will have to pay a 20% penalty on the
Non-qualified expenses will not count toward your deductible
Once you are 65, you can withdraw the money without penalty, but it will be considered taxable income
14
Can I Still Have an FSA?
You can, if your employer offers one of the following limited purpose FSAs:
A limited purpose FSA which limits reimbursements to eligible dental and vision care; or,
A limited purpose high deductible FSA (LPHD FSA) provides immediate reimbursement of your dental and vision expenses as well as reimbursement of your qualified medical expenses once your deductible requirement is met
Funding Your HSA
16
Making Contributions to Your HSA
There are several ways you can contribute to your account:Tax-free through payroll deductionsPost-tax by personal check
When you file your taxes, you can make an adjustment to your gross income to receive the tax benefit
You’ll receive deposit slips for your HSA in the mail
Anyone may contribute to your HSA, provided the total contributions to your HSA do not exceed your maximum allowable annual limit
$3,050 for individual coverage$6,150 for family coverage
You can make catch-up contributions if you are 55 years of age or older ($1,000 for 2011)
17
HSA Tax Benefits
Contributions made via payroll deduction are pre-taxReduces your federal adjusted gross income
(the amount you pay tax on)
Contributions made by personal check are post-taxYou will need to make an adjustment on your gross income
when you file your taxes to receive the tax benefit
If you use your HSA for a non-qualified expense (e.g. not covered services or qualified medical expenses), you will have to pay tax on the expense and are subject to a 20% penalty on the amount.
18
Am I Eligible for the HSA Plan?
The IRS and the U.S. Department of the Treasury have specific rules on who can open an HSA.
You can open an HSA if you: Are enrolled in the Lumenos HSA plan, because it includes
an HSA-compatible health plan
Are a U.S. resident and not a resident of Puerto Rico or American Samoa
Are not enrolled in Medicare or another non-qualified plan
Are not claimed as a dependent on another individual’s tax return
Are not active military
Others – refer to online health site
Note: You cannot open an HSA if you have coverage under any other health plan that is not an HSA-compatible health plan.
19
Who is Holding the Funds in My HSA?
A qualified financial institution will hold and invest the money. Hebrew Union has Partnered with 5/3.
Services provided: Your debit card and PIN
Your HSA checkbook
FDIC insurance
Monthly account statements
Year-end tax forms
*If your employer has selected a financial institution to administer your HSA that is not one of Anthem’s partner banks, or you choose to have your HSA at a different bank, you will not have access to HSA information through Anthem Customer Service or the online health site. Investment rules and fees for your account may also vary.
20
Employee Monthly Contributions
Base Plan or HSA Plan
The current Salary Based Tier will continue:
Salary under $35,000 is charged 1.75 % for single and 3.25% for Family.
Salary $35,000 to $50,000.00 is charged 2.25% for single and 3.75% for family.
Salary over $50,000 – is charged 2.75% for Single and 4.25% for family.
Buy Up Plan
Buy Up Single = % of salary noted above plus an additional $131.04 per month
Buy Up Family = % of salary noted above plus an additional $393.14 per month
21
Dental Insurance- Guardian
The Dental plan design with Guardian will remain the same.
In Network- Calendar Year Benefits
Deductible: Single $50; Family $150 (waived for Preventive)
Annual Maximum Per Person: $1,000
Preventive: Covered in Full
Basic Service: Covered at 80% after deductible
Major Service: Covered at 50% after deductible
Orthodontia: Covered at 50% to $1,000 lifetime maximum per dependent child up to age 19
To look up a provider please log on to www.guardian.com.
Customer Service-1-800-541-7846
2011-2012 Monthly Employee Contributions
Single: $8.31
Family: $35.79
Flexible Spending Account
23
What is a Flexible Spending Account or FSA?
Pay expenses with tax-free money
Three Accounts- Health Care, Limited Purpose (for HSA participants) & Dependent Care
Voluntary election of payroll deductions
Money held in your name
Submit claim for reimbursement
24
Think of what you buy with your money. . .
Deductibles
Rx Drugs
Copayments
Day Care
Eyeglasses/Contacts
Lasik Surgery
Dental Work
OTC Provision
25
Flexible Spending Account Health Care ReimbursementEligible Expenses- see FSA packet$7,000 Maximum limitUse worksheet to estimate total expensesCalculate total contribution
Dependent Care ReimbursementEligible Expenses- see FSA packetIf married, spouse must work or attend school full-timeMaximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return
26
Flexible Spending Account Limited Purpose Account
Limited Purpose Flexible Spending Account is a tax savings account that reimburses employees for eligible dental and vision care expenses in conjunction with a HSA.
Eligible Expenses- dental and vision only$7,000 Maximum limitUse worksheet to estimate total expensesCalculate total contribution
27
Open Enrollment Summary
Health Insurance- If you do not want to switch plans your plan will automatically renew.
HSA Bank Account- More information will be emailed out to the campus on how to enroll and set up your H.S.A. bank account if you enroll in the H.S.A plan.
FSA- Please complete the enrollment form and turn it into the Cincinnati Benefits department
If you would like to make any changes to your Dental, Life or Supplemental Life please contact HR for a change form. As a reminder there is not an open enrollment for Dental. If you would like to increase your supplemental life insurance evidence of insurability is required. You will be approved or declined based on your current health status.
ALL FORMS ARE DUE TO HR NO LATER THAN JUNE 20th
28
Questions?