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Lawrence Holdings, Inc. Open Enrollment – Effective January 1, 2012

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Lawrence Holdings, Inc. Open Enrollment – Effective January 1, 2012. Presentation Agenda. What’s new for 2012 Your benefit choices National Data on Employee Medical Benefits Your employee contributions What you need to do to enroll Question & Answer. - PowerPoint PPT Presentation

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Page 1: Lawrence Holdings, Inc

Lawrence Holdings, Inc.Open Enrollment – Effective January 1, 2012

Page 2: Lawrence Holdings, Inc

What’s new for 2012

Your benefit choices

National Data on Employee Medical Benefits

Your employee contributions

What you need to do to enroll

Question & Answer

Presentation Agenda

Page 3: Lawrence Holdings, Inc

NO BENEFIT CHANGES …!!!

What’s Happening for This Year

What’s New for 2012…???

Page 4: Lawrence Holdings, Inc

Two medical plan options through Anthem BCBS

◦ High PPO & Core HRA

Dental plan through Delta Dental

◦ Dental PPO

Vision plan through VSP

Life/AD&D and Short/Long Term Disability through MetLife

2012 Program Highlights

Page 5: Lawrence Holdings, Inc

Plan Design – Medical: Core HRAPlan Feature In-Network Out-of-Network

Deductible (individual/family) $1,500 / $3,000

Health Reimbursement Arrangement (HRA) Account

$1,100 / $2,200

Out-of-Pocket (individual/family) * $5,000 / $10,000 $10,000 / $20,000

Physician Office Visits 80% AD 60% AD

Preventative Care $0, No Deductible 60% AD

Inpatient Hospital 80% AD 60% AD

Outpatient Hospital 80% AD 60% AD

Emergency Services 80% AD 60% AD

Pharmacy 80% AD 60% AD

* Includes deductible; AD = After Deductible

Page 6: Lawrence Holdings, Inc

Plan Highlights:◦ Available for Core Plan enrollees only

◦ LHI will provide enrollees with partial deductible reimbursement based on their enrollment status:

Employee only coverage $1,100

Employee + Family coverage $2,200

◦ Participants pay their portion of the deductible first, then are eligible to be reimbursed for the remainder up to the HRA credit maximum

◦ Administered by COBRAsource Claim forms submitted COBRAsource

Obtain claim forms from HR representative

Core Plan: HRA – How it works ?

Page 7: Lawrence Holdings, Inc

Plan Design – Medical: High PPOPlan Feature In-Network Out-of-Network

Deductible(individual/EE+1/family)

None $2,000 / 4,000 / $6,000

Out-of-Pocket(individual/EE+1/family) *

None $8,000 / $16,000 / $24,000

Physician Office Visits $30 PCP /$45 Specialist

30% AD(member responsibility)

Preventative Care $0, No Deductible 70% AD

Inpatient Hospital 100%$500/day co-pay up

to $2,000 max

70% AD

Outpatient Hospital 100% 70% AD

Emergency Services $150

Pharmacy Retail (30 day supply): $10 / $25 / $40Mail Order (90 day supply): $20 / $50 / $80

* Includes deductible; AD = After Deductible

Page 8: Lawrence Holdings, Inc

National Benchmark Data:Average In-Network Plan Deductible

In-Network Deductible(average Family deductible is 3x)

$0

$500

$1,000

$1,500

$2,000

$2,500

$0

$400$350

$1,000

$500

$1,000

LHIIndustry (Manufacturing)Region (Northeast)Small Employers (10-499)Large Employers (500+)All Employers

Page 9: Lawrence Holdings, Inc

In-Network Coinsurance0%

10%

20%

30%

40%

50%

0%

20%

10%

20% 20% 20%

LHIIndustry (Manufacturing)Region (Northeast)Small Employers (10-499)Large Employers (500+)All Employers

National Benchmark Data:Average In-Network Plan Coinsurance

Page 10: Lawrence Holdings, Inc

In-Network Deductible(average Family OOP is 3x)

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

$4,500

$0

$2,000

$1,500

$2,500

$2,000

$2,500LHIIndustry (Manufacturing)Region (Northeast)Small Employers (10-499)Large Employers (500+)All Employers

National Benchmark Data:Average In-Network Out-of-Pocket Max

Page 11: Lawrence Holdings, Inc

In-Network Deductible(average Family HSA deductible is 2x)

$0

$500

$1,000

$1,500

$2,000

$2,500

$3,000

$3,500

$4,000

$4,500

$1,500

$1,500

$1,500

$2,500

$1,500

$2,500LHIIndustry (Manufacturing)Region (Northeast)Small Employers (10-499)Large Employers (500+)All Employers

National Benchmark Data:Average In-Network HRA/HSA Deductible

Page 12: Lawrence Holdings, Inc

ERs who offer HSA / CDHPas part of multiple plans

ERs who Offer HSA / CDHP

as exclusive medical plan

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

23%

6%

17%

4%

13%

41%

17%

9%

13%

40%

Industry (Manufacturing)Region (Northeast)Small Employers (10-499)Large Employers (500+)All Employers

National Benchmark Data:Impact of Consumer Driven Healthcare

Page 13: Lawrence Holdings, Inc

Tobacco-Free Program◦ 100% coverage for telephone counseling and educational materials

◦ Also covers nicotine replacement therapy

Healthy Weight Program◦ 100% coverage for telephone counseling with a registered dietician &

health educator

◦ Includes on-line tools and educational materials

Other Programs◦ Stress Management

◦ Physical Activity

Core Plan members can earn rewards for activities that contribute to good health & well being

Wellness Options: Anthem BCBS Healthy Programs Available to ALL Medical Plan Participants

Page 14: Lawrence Holdings, Inc

* Fees by Premier Network dentists will be discounted & the dentist’s office will not bill patient for more that ‘approved’ fees. No Balance Billing to Patient.

www.deltadentalnj.com

Or call

1-800-DELTAOK

Plan Design: Dental Plan SummaryDelta’s Two Networks – The PPO & The Premier

Plan FeaturePPO In-Network

Premier Dentists*

Out-of-Network

Deductible (individual/family) $50 / $150

Preventative (NO deductible) 100% 80% 80%

Basic Services 90% 80% 80%

Major Services 60% 50% 50%

Annual Dental Maximum $1,500

Orthodontia (dependent children) 50%

Ortho Lifetime Maximum $1,000

Page 15: Lawrence Holdings, Inc

Plan Design: Basic & Voluntary Life/AD&D

* You may apply for these coverages by filling out the application form for them along with the simple health statement and submitting for carrier approval.

Plan Feature Benefit

Basic Life Insurance 1 x Base Annual Salary to $150,000

Basic AD&D 1 x Base Annual Salary to $150,000

Optional Employee Life Increments between $10,000 and $500,000(portable with $20,000+ elected)

Optional Spousal Life Increments between $5,000 and $250,000but may not be more than 50% of EE amount

(portable with $20,000+ elected)

Optional Child/ren Life $10,000

Page 16: Lawrence Holdings, Inc

Plan Design: Short & Long Term Disability

* Note: California employees are covered under the California State Disability Income (CASDI) program; the MetLife STD benefit will integrate with CASDI for a total benefit up to, and not exceeding, 60%.

Plan Feature Benefit

Short Term Disability Weekly Benefits = 60% of Annual Salary to a max of $2,000 per week for up to 13 weeks

duration

Long Term Disability Monthly Benefits = 60% of Annual Salary to a max of $10,000 per month

Page 17: Lawrence Holdings, Inc

Plan Design: Vision PlanPlan Feature In-Network Out-of-Network

Exams $10 copay Up to $45 allowance

Frames $25 copayUp to $130 allowance + 20%

discount over allowance

Up to $47 allowance

Lenses $25 copay Up to $45-$125 allowance

Contact Lenses $25 copayElective: up to $130

allowanceMedically Necessary: $0

Elective: up to $105 allowance

Medically Necessary: up to $210 allowance

Frequency (all services) 12 months

Lasik Surgery 5%-15% Discount N / A

Page 18: Lawrence Holdings, Inc

Employee Contributions: Medical

* Note: These are the amounts that you pay each month for these coverages if you elect them. They are not the amounts that are taken out of each of your paychecks.

Employee TierHigh Plan

PPOCore Planwith HRA

Employee $180.63 $77.91

Employee + 1 $397.49 $171.35

Employee + Family $487.70 $210.06

NO CHANGES……!!!

Page 19: Lawrence Holdings, Inc

Employee Contributions: Dental & Vision

* Note: These are the amounts that you pay each month for these coverages if you elect them. They are not the amounts that are taken out of each of your paychecks.

Employee Tier Dental Vision

Employee $8.00 $0.00

Employee + 1 $23.05 $2.51

Employee + Family $36.85 $7.02

NO CHANGES……!!!

Page 20: Lawrence Holdings, Inc

Employee Contributions: Medical

* Note: These benefits are provided by Lawrence Holdings at no cost to you.

NO CHANGES……!!!

Benefit Employee Cost Sharing

Basic Life Insurance None *

Basic AD&D None*

Optional Employee Life 100% Employee Paid

Optional Spousal Life 100% Employee Paid

Optional Child/ren Life 100% Employee Paid

Page 21: Lawrence Holdings, Inc

During open enrollment: you can add or delete dependents OR enroll in a plan that you have previously waived coverage for (some waiting periods may apply).

If you have an IRS “qualifying life event” (QLE): Due to IRS regulations the elections you make for January 1st cannot be changed unless you have a qualified status change OR life event. You can add or drop dependents to/from your plans if one of the following status changes occur during the plan year.

The addition of a dependent through marriage, birth, adoption, etc.

The loss of a dependent through divorce, death, or if a dependent looses eligibility (due to age, employment, etc.)

A change in spouses employment or benefit eligibility status

A substantial/material change in your, or your spouse’s, benefits coverage

PLEASE NOTE: changes must be made within 30 days of the qualifying event OR you must wait until the next qualifying event / plan open enrollment.

Changing your Coverage Elections

Page 22: Lawrence Holdings, Inc

Key Enrollment Dates

• You will only need to complete new applications IF you are changing any of your coverage selections from your 2011 elections.

• All employees will need to complete and sign the LHI election/waiver form reaffirming selections for 2012, and initial benefit summary page.

Activity Timing

Open Enrollment Meetings November 30 – December 9th

Open Enrollment Period Ends December 22nd

Enrollment Elections Due to HR December 22nd

Plan Year Effective Date January 1st, 2012

Page 23: Lawrence Holdings, Inc

QUESTIONS ?

Thank you for attending !

The purpose of this presentation is to help answer questions and provide a summary of the employee benefits plans offered by Lawrence Holdings, Inc effective 1-1-2012. Please contact your HR representative with any further questions or

for clarification instead of assuming anything. Though efforts have been made to ensure the accuracy of this information, it is subject to modification at any time. As always, LHI reserves the right to change or end any of its benefit

plans at any time.

Erin Ethier

Lawrence Holdings, Inc

1.866.949.1699 ext 6606

Charles Andersen

RSC Insurance Brokerage

1.312.506.8828

/