benefits open enrollment meeting effective january 1, 2013

© 2010 Wittenberg University Springfield, Ohio 45501

Benefits Open Enrollment Meeting

Effective January 1, 2013


AgendaI. Consumerism TipsII. Healthcare Reform Updates

Women’s Preventive Care Enhancements FSA Healthcare Maximum

III. New Benefits Options Voluntary Life Insurance One Time Guarantee Issue Opportunity! New Voluntary Life Benefits for Spouses and Dependents

IV. Medical Insurance Plan Design Review/ Employee Contributions- GREAT NEWS! No changes

V. Dental Insurance Plan Design Review/Employee Contributions- GREAT NEWS! No Changes!

VI. Vision Plan Plan Design Review/Employee Contributions- GREAT NEWS! No Changes!

VII. Flexible Spending AccountVIII. Enrollment Process and DeadlinesIX. Resources

www.anthem.com www.tasconline.com Express Scripts HR Webpage


What if the cost of these items had increased as rapidly as healthcare costs (1975-2012)?

Toyota Corolla: $104,442

25” Color TV: $20,357

1 Bottle NyQuil: $36

Oil Change: $162

32oz Listerine: $37

Basic Corded Drill:$423

2lbs Sirloin Steak:

$77

1 Movie Ticket: $37


Healthcare Reform Legislation New Mandates High Utilization of Benefits Unhealthy Lifestyle Choices Plan Designs New Brand Name Drugs New Technologies & Treatments Aging Population Defensive Medicine / Malpractice

What Impacts Your Health Plan Cost?


Use your benefits wisely! Use In-Network Providers Use Generic Rx Get your Annual Check-ups Get your Flu Shot Urgent Care Clinic vs. ER …and of course EAT HEALTHY AND EXERCISE!

What Can You Do?


1. How much does that cost?

2. Is this procedure really necessary?

3. Is there a less expensive option?

4. Is there a Generic Rx?

5. Has anybody out there had this before?

(Do your own research online!)

Five Smart Questions to Ask:


Low-Cost / Free Generic Drugs

$4 for 30-day supply $10 for 90-day supply Free antibiotics available at some locations Do NOT use your medical ID card, just

present your doctor’s prescription EXCELLENT time to review list for your brand

name medication and check with your doctor to see if you can switch to the generic

Resources – Low Cost Rx


Resources – Convenient Care ClinicsDesigned for non-emergency care – example

treatments:• Respiratory Illnesses • Additional Treatments • Skin Conditions • Minor Injuries • Diagnostic Testing • Vaccinations

Staffed by Nurse Practitioner or Physician’s AssistantCare typically available for an office visit copay


Healthcare Reform Updates


Women’s Preventive Care EnhancementsThe following benefits will be covered in full effective January 1, 2013 when utilizing Anthem network providers:•Screening for gestational diabetes•Testing for human papillomavirus (HPV)•Counseling for sexually transmitted infections•Screening for counseling for Human immunodeficiency virus (HIV)•FDA-approved contraception methods and contraceptive counseling•Breastfeeding support, supplies and counseling•Screening and counseling for interpersonal and domestic violence


FSA – Healthcare Annual Maximum Changefor Jan. 1, 2013 effective date

Healthcare FSA

• $2,500 annual maximum limit required by healthcare reform (previously $3,000)


New Benefit Options


Voluntary Life Insurance Employee

– $10,000 increments to a maximum of $1,000,000 not to exceed 3x annual earnings ($50,000 for ages 70 or older prior to age reductions)

– $200,000 of coverage is available on a guaranteed issue basis during this open enrollment only.

– Unique opportunity to purchase additional life insurance without having to complete evidence of insurability paperwork.

Additional Features– Portability– Accelerated Death Benefit


Voluntary Dependent Life Insurance- New Benefit!

Spouse (includes domestic partners)– $5,000 increments up to $100,000 not to exceed 50% of the

employees elected coverage amount.– Guarantee Issue:

• Spouses: $30,000

Children – 6 months and older can receive $10,000 benefit for each child on

a guarantee issue basis (up to age 19, or 25 if full-time student).– Coverage from 14 days to 6 months is $250.

– The Employee must elect coverage to enroll Spouse and/or Dependent Children.


Who needs Voluntary Life?Singles - Even if you do not have dependents, Voluntary Life benefits can pay for

your: – Student Loans, Car Loans, Credit Cards, Funeral Costs– Other debts that may be passed on to your parents or siblings

Young Families - All of the obligations of a single person plus:– Mortgage, College Savings, Retirement planning– Many other expenses related to the well being of your spouse and children

Empty Nesters - Although your children are on their own your spouse will need help:– Mortgage, Retirement, Funeral expenses, Funds to support your

grandchildren


2013 Benefits Review


General Information• Plan is Effective 01/01/2013

• Self-Funded Plan subject to ERISA and plan document

• Partnering with Anthem Blue Cross & Blue Shield

Blue Access PPO network – national network

• 4 Plan Types: Employee plan, Employee + spouse plan,

Employee +children plan, & Family plan


General Information• Open Enrollment for 2013- Oct. 22nd - Nov. 16th

• Qualifying Event – You can only join a plan or make benefit election changes during an open enrollment period unless you experience a qualifying life event change as defined by IRS.

• Examples: change in marital status, birth or adoption of a child, change in spouse’s employment status. You must contact Human Resources to complete an enrollment form within 31 days of the event.


Glossary of Terms• Co-pay – a flat dollar amount that is paid at the time of service. Co-pay

does not apply to the deductible

• Deductible – annual amount of money a member must pay before benefits are paid at the co-insurance % .

• Co-insurance – a percentage that a member pays for services received after they have met their deductible. Member pays in full

until deductible is met.

• Out-of- pocket limit – the most an employee would pay in deductible and co-insurance during a plan year (Jan-Dec) for

healthcare services excluding prescription drugs.

Services with a % = Co-insurance .

Services with a $ = Co-pay .


Wittenberg’s Blue Access PPO Health Plan

MEMBER PAYS

Deductible $400 individual /$800 familyEmergency Room Services 10% after deductible

In-Network BenefitOut-of-Pocket Limit $1,200 individual /$2,000 familyPhysician Office visits $20 co-payPreventive Care visits Covered at 100%Urgent Care $20 co-payInpatient/Outpatient Services 10% after deductible


Wittenberg’s PPO Health PlanOut-of-network benefit

Out-of- Pocket Limit $1,300 individual /$2,200 family

Physician Office visits 30% after deductiblePreventive Care visitsUrgent CareInpatient/Outpatient Services

Balance billing: Providers and hospitals who are out-of-network will bill you for the difference between the amount the plan pays and their billed charges.


Deductibles and Out-of-Pocket Limit

Deductible The $400/$800 deductible simultaneously applies to both in and out-of-network services. In other words, there is not a separate deductible for out-of-network.

Out-of-Pocket Limit (“OOP”) There is a separate out-of-pocket limit for in-network and out-of-network co-insurance expenses.

Co-insurance costs for services received in-network only apply tothe in-network OOP. Co-insurance costs for services received out-of- network only apply to the out-of-network OOP.

In-network - $1,200/$2,000Out-of-network - $1,300/$2,200


Wittenberg Prescription Benefit

Prescription Drug Retail $10/$25/$40

Express Scripts Prescription Drug Mail Order $20/$50/$80

3-month supply

Prescription co-pay OOP limit $1,200 single/$2,000 family

Note: Prescription OOP limit is completely separate and unrelated to the OOP for medical.


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How to Find a Provider

• www.anthem.com• Click on “Find a Doctor”• Choose the search option of your choice• Choose the state that you want to search• Choose a Plan (PPO)• You can then search by provider name, address, zip

code, etc.• Or call the customer service number listed on the back

of your ID card


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Monthly Contributions- MedicalNo Cost Increase in Calendar Year 2013

Plan Type Total CostAnnual/Monthly

Wittenberg 80%Annual/Monthly

Employee 20%Annual/Monthly

Single $5,556.00/$463.00 $4,440.00/$370.00 $1,116.00/$93.00

Employee Plus Spouse

$13,884.00/$1,157.00 $11,112.00/$926.00 $2,772.00/$231.00

Employee Plus Children

$13,428.00/$1,119.00 $10,740.00/$895.00 $2,688.00/$224.00

Family $20,688.00/$1,724.00 $16,548.00/$1,379.00 $4,140.00/$345.00


Wittenberg Dental Blue Complete Plan

MEMBER PAYS

Deductible $25 single /$75 family

Annual Maximum (per covered member) $1,500

Diagnostic and Preventive No Charge to member

Minor Restorative 20% after deductible

Oral Surgery 20% after deductible

Endodontic Services 20% after deductible

Periodontal Services 20% after deductible

Prosthodontic Services 50% after deductible

Orthodontic Services 50% no deductible

Orthodontic Lifetime Maximum $1,000

Orthodontic Age Limit Child to age 19


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Monthly Contributions- DentalNo Cost Increase in Calendar Year 2013

Plan Type Total Monthly Cost Wittenberg 80% Employee 20%

Single $25.00 $20.00 $5.00

Employee Plus Spouse

$62.00 $50.00 $12.00

Employee Plus Children

$59.00 $47.00 $12.00

Family $91.00 $73.00 $18.00


Claims Assistance

If you are having trouble resolving a claim issue USI Insurance can assist you.

If after you have reached out to Anthem your questions were not answered or it is a complex claim issue please contact Paula Meyers at 1-877-778-7469 or you can email her at [email protected].


Anthem Blue View Vision Benefit Plan for Active Employees

Network BenefitsRoutine Eye Exam (once every 12 months) $10 co-payEyeglass Frames (once every 24 months) $100 allowance/20% off the remaining balance

Eyeglass Lenses (standard)Standard Plastic Single vision lenses (1 pair) $15 co-pay, then covered in fullStandard Plastic Bifocal lenses (1 pair) $15 co-pay, then covered in fullStandard Plastic Trifocal lenses (1 pair) $15 co-pay, then covered in full

Eyeglass lens upgradesUV coating, Tint, Standard Scratch-Resistance $15 co-pay per upgradeStandard Polycarbonate $40 co-payStandard Progressive $65 co-pay standard Anti reflective coating $45 co-payOther add-ons and services 20% off retail price

Contact Lenses Elective Conventional Lenses $105 allowance/15% off the remaining balanceElective Disposable Lenses $105 allowance (no add’l discount) Non-Elective contact Lenses Covered in Full


Active Employee Monthly Contributions Vision Plan

Plan Type Employee Monthly

Single $3.00

Employee Plus One $6.00

Family $10.00

Contributions are tax -sheltered


Flexible Spending Account (FSA)

TASC Third Party Administrator

tasconline.com

By using PRE-TAX dollars, Flexible Spending Accounts help you take advantage of tax savings on eligible health care and dependent care expenses.

Wittenberg offers you two reimbursement accounts:

1. Health Care Reimbursement Account (for your eligible health care expenses not covered by insurance)

2. Dependent Care Reimbursement Account(for reimbursement of day care expenses for eligible dependents).


FSA - What is it?• You set aside funds in an FSA to cover your out-of -pocket medical or dependent

care costs. You need to decide upfront how much money you want to elect for the calendar year.

• Voluntary election of payroll deductions on a pre-tax basis. Savings of nearly 30% is the Rule of Thumb – Use the TASC On-line Tax Savings Calculator to estimate your tax savings. http://www.tasconline.com/buytasc/flexsystem/

• You cannot change your election unless you have a qualifying event. Also, you cannot transfer money from one account to another.

• “Use it or Lose it” - You have a grace period of three months after the end of the calendar year to submit claims for eligible expenses incurred duringthe previous calendar year. Any money left in your account after the three months will be forfeited.


FSA – Enroll Now for Jan. 1, 2013 effective date

Healthcare FSA

• $2,500 annual maximum limit

• You have immediate access to your full election at the onset of the calendar year even though the full election has not been deducted from your pay.


FSA - Enroll Now for Jan. 1, 2013 effective date

Dependent Care FSA

• If married, spouse must work or attend school full-time

• Maximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return

• Under IRS guidelines, you can only be reimbursed for dependent care that has already taken place. Also, you can only be reimbursed for the amount you have already contributed to your dependent care FSA.

• Eligible expenses include dependent care expenses for children under age 13, a disabled spouse, and/or a disabled relative or household member who depends on the account holder for at least half of his orher support.


FSA Reimbursement

• You can request reimbursement by • Fax – 608-663-2762• Mail – TASC, P.O. Box 7308 , Madison, WI 53707-7308• On-line – www.tasconlin.com

• 24-hour turnaround on reimbursements via Direct Deposit.

• Use the FlexSystem Claim Card for seamless real-time payments. You can also order a card for your spouse.

• Instant account status availability on-line or via FlexSystem’s voice response system.

• Toll-free customer service assistance 800-422-4661


FSA Card How to use your Claim Card:

You may use the card like a credit card when you pay for eligibleexpenses at the point of service. The funds are automatically deducted from your Flex Account balance. It is important to remember that you may still need to submit substantiation upon request.

Where to use the card:•Medical and dental physicians•Vision care providers•Medical facilities•Drug stores and in-store pharmacies •Hospitals including emergency rooms•Dependent care providers who accept Visa


FSA Open Enrollment Anyone who wants to participate in an FSA must enroll or

re-enroll for 2013. If you were enrolled in 2012, an email will be sent to you

with re-enrollment information and you can re-enroll online. If you are enrolling for the first time, you’ll need to complete a paper enrollment form.

Enrollment DEADLINE IS NOVEMBER 16th . If you are re-enrolling please keep your existing TASC cards (no new

cards will be sent). New enrollees will get an email about the card and information will be mailed to your home address about 10 days after enrolling.


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Medical, Dental, Vision and Voluntary LifeOpen Enrollment

You need to complete an enrollment form if:

You want to enroll in the Medical, Dental or Vision Insurance programs for the first timeYou want to add or drop your spouse or dependents from your coverageYou want to cancel your one or more of the plans your currently participate in You would like to enroll you and/or your dependents in the Voluntary Life Insurance

You DO NOT need to complete any paperwork if:

You are currently enrolled in the medical and dental plan; want to remain on both plans and do not want to add or drop your spouse or dependentsYou do not need to enroll or change your currentVoluntary Life Insurance

Reminder: Employees can enroll in Medical and/or Dental independently.

DEADLINE TO TURN IN FORMS IS NOVEMBER 16th .


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Questions?

THANK YOU FOR YOUR TIME!

benefits open enrollment meeting effective january 1, 2013

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