TODAYS TOPICS Open Enrollment McGohan Brabender Who we are and how can we help you Core Benefits MedicalRx Benefits Dental Benefits Vision Benefits Life amp Disability Benefits What do you need to do ID: 934974
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Slide1
April 23 – May 19Benefits Effective July 1, 2018
Slide2TODAY’S TOPICS
Open Enrollment
McGohan Brabender:
Who we are and how can we help you?Core Benefits
Medical/Rx Benefits Dental Benefits
Vision Benefits
Life & Disability Benefits
What do you need to do?
Questions
Slide3SUPPORT SERVICES
McGohan Brabender Customer Care Team
Should you have questions on claims, coverage, billing, etc. MB can help. MB’s Customer Care Team can call the carrier on your behalf and resolve the issue:
1.937.260.4300 or 1.877.635.5372
e-mail us at: CustomerService@mcgohanbrabender.com
Hours of Operation:
M – F 8:00 a.m. – 5:00 p.m. EST
HR
Should you encounter issues that you are unable to resolve, please call:
Elizabeth Foos
HR Department: 740.368.3327
Email
:
ekfoos@owu.edu
Medical Overview:
Staying with Anthem
Effective
July
1, 2018. Employees will have
TWO plan
choices:
PPO 1000 & HDHP 3000
The
plans offer:
Comprehensive Medical Coverage
Preventive Care Services are covered 100% (in-network)
Prescription Drug Plan
Discounted Rates with
Providers
Features of the HDHP:
Lower premiums for the higher deductible
Tax savings
OWU contribution to the HSA
Slide5IN-NETWORK BENEFITS
PPO 1000
HSA 3000
Deductible
$1,000 / $2,000
$3,000 / $6,000
Deductible Plan Year or Calendar Year
Calendar Year
Calendar Year
(any previous PPO deductible accumulated will be counted towards HDHP deductible)
Embedded or Aggregate?
Embedded
Embedded
Coinsurance
10%
20%
Out-of-Pocket Maximum
(Includes Deductible)
$3,500 / $7,000
$6,000 / $12,000
Office Visit Co-pay
$30 Co-PayDeductible then co-insuranceSpecialist$60 Co-PayDeductible then co-insuranceUrgent Care Co-pay$75 Co-PayDeductible then co-insuranceEmergency Room$250 Co-PayDeductible then co-insuranceWellness/Preventive CareCovered at 100%Covered at 100%Prescription Drug – Retail Copay $10 / $35 / $70 / 25% Deductible then co-insurancePrescription Drug - Mail Order Copay$10 / $65 / $120 / 25%Deductible then co-insurance
Slide6THE HSA WORKS WITH THE HDHP
HDHP = The MEDICAL PlanThe HDHP provides
coverage
after the annual deductible is met and
preventive care services
are covered at 100%.
HSA = The BANK Account
Funds in
the HSA
can
be used to pay
for eligible medical, dental and vision related expenses.
Helps Pay Your deductible
Tax-Deductible Deposits
Tax-Deferred
Growth
Tax-Free
Withdrawals
For Medical Care
HealthSavings Account(HSA)
Slide7HSA ADVANTAGES
You own the account
You decide to pay for current or save for future expenses
You decide how much is deposited
An HSA builds over time (not use it or lose it)
Opportunity to invest
Retirement
Savings
Contributions are Pre-tax (through Section 125 plan). Federal, State, FICA and local tax savings.
Any contributions made after tax would be an above the line deduction.
HSA funds accumulate tax-free
A beneficiary would be designated on the account in the event the account holder passes away
.
Qualified expenses paid with PRE-TAX dollars!
Slide8FLEXIBILITY
Ability to change your contribution throughout the year
With HR approval you can start, stop, increase and/or decrease your contributions through payroll deduction throughout the year.
You never lose access to the funds in your HSA even if you:
Don’t use it by the end of the year –
the money rolls over and you maintain the opportunity to contribute up to the yearly maximum.
Terminate or transfer employment –
you own the account, all funds stay with you.
Terminate enrollment in a HDHP –
at this point you can no longer make contributions but can still use the funds for qualified expenses.
OWU’s HSA Contributions
$1,500 / Single $3,000 / Family
Contribution Limit: $3,450 / Single, $6,850 / Family (these contribution limits include OWU’S HSA contribution)
Slide9HOW CAN I USE MY HSA FUNDS?
Childbirth Classes
COBRA Premiums
Co-Insurance Amounts
(after deductible is met)
Contact Lenses/Solutions
Deductible Expenses
Dental Treatment
Eye Exams/Eyeglasses
Health Insurance Premiums
(Retiree or while drawing unemployment)
Hospital and ER Services
Laboratory Fees
Medicare Premiums
Long Term Care Premiums
Orthodontia
Over the Counter Medication when a script is obtain from a physician
Insulin
Physical Therapy
Radial Keratotomy/Lasik Surgery
Smoking Treatment Program Speech Training Vaccines Weight Loss Programs(prescribed for illness)Funds withdrawn for qualified expenses are tax free when used to pay for eligible health care expenses. Some example are:
Slide10RECORD KEEPING
Who is responsible for keeping track of what the HSA funds are used for?
YOU ARE.
You should keep a listing of ALL of the withdrawals that occur from the HSA and the qualified medical expenses they correspond to in case needed to:
Provide proof to the IRS that distributions from HSA were for qualified medical expenses
Provide proof that the deductible was met under the HDHP
NOTE: Not all medical expenses paid out of the HSA have to be charged against the deductible. (i.e. dental care, vision care) in order to be considered “qualified,”; however
,
all non-qualified withdrawals are subject to income taxes and a 20% IRS penalty.
You will be required to file a Form 8889 with your annual tax return. Your bank will report contributions and distributions to both you and the IRS.
FSA Overview
HRPro
Flex Spending $2,650 & Dependent Care $5,000
$500 Carryover if enrolling in the 2018-2019 plan
Benny Card: You will keep the same card, HR Pro will reload July 1
st
KEEP ALL RECEIPTS for your records and in case of IRS inquiry
Check your current balance at
http://hrpro.biz/
,
https://hrpro.navigatorsuite.com/login.aspx
GoodRX
GoodRx is a discount Rx Site
Here's
how you can use it to save:
Use
GoodRx's drug price search to compare prices (just like you do for travel or electronics on other sites) for your prescription at pharmacies near you.
They
don't sell the medications,
They
tell you where you can get the best deal on them.
GoodRx
will show you prices, coupons, discounts and savings tips for your prescription at pharmacies near you
.
Slide13PREVENTIVE CARE
Your
preventive care
is
covered.
immunizations
well-woman check
well-child check
mammogram
blood pressure tests
cholesterol tests and more
No symptoms, illness, or history prompting the screening
In accordance with age and gender guidelines
Preventive
Care
Symptoms
require further
diagnosis
Previous abnormal test results prompt earlier or more frequent
screenings
Previous abnormal test results prompt rescreening.
Diagnostic
Slide14Decision Support Tool Demo and Monthly/Annual Rates
Monthly Rates effective July 1, 2018
Tier
1000
PPO
3000 HDHP
Under $35,999
Employee
$56.60
$28.30
Employee/Spouse
$227.04
$113.52
Employee/Child(ren)
$204.09$102.05Family$356.94$178.47 $36 - $59,999 Employee$91.08$45.54Employee/Spouse$297.08$148.54Employee/Child(ren)$267.66$133.83Family$457.14$228.57 $60 - $89,999 Employee$123.41$61.70Employee/Spouse$367.11$183.56Employee/Child(ren)$331.23$165.62Family$556.27$278.14 $90,000+ Employee$156.81$78.40Employee/Spouse$437.15$218.58Employee/Child(ren)$395.88$197.94Family$655.40$327.70
Slide15WHICH PLAN IS RIGHT FOR YOU?
Decision Support Tool
Please come and meet with us afterwards!
Reminder:
OWU contributes a total of $1,500 / $3,000 into your HSA throughout the year. You can always change your plan next year.
Slide16Anthem Tools: Live Health
Slide17Slide18Healthcare BlueBook
Video:
http://
www.screencast.com/t/LEVczsPj5
Slide19The Program
Sign up today by visiting
www.retiremediq.com/mb
Questions? Call
RetireMED®iQ
at
1-866-600-4266
Slide20DENTAL
Preferred Plan Network Benefits
LOW PLAN
HIGH PLAN
Deductible
$50 / $150
$50 / $150
Annual Maximum
$1,000
$1,500
Preventive Services
(Deductible Waived)
Covered at 100%
Covered at 100%
Basic Services (ded. applies)
80%
90%
Major Services (ded. applies)
50%
60%
Child Orthodontia
N/A50%Ortho. Lifetime MaxN/A$1,000Dental PremiumsPer MonthEmployee ContributionLOW PLANHIGH PLANEmployee Only$26.27$36.71Employee + 1$51.51$72.73
Family
$84.14
$118.26
We are
staying with Anthem Dental
for
benefits
!
Slide21VISION
Benefits
LOW PLAN
HIGH PLAN
Exam
$20 Co-Pay
$10 Co-Pay
Frames
$130 allowance
$150 allowance featured brands
20% savings on the amount over your allowance
$140 allowance
$160 allowance featured brands
20% savings on the amount over your allowance
Lenses
:
Single
Bifocal
Trifocal
Covered in full after $20 Co-Pay
Covered in full after $20 Co-Pay
Contact LensesUp to $130 in allowance; Co-pay up to $60Up to $140 allowance for contacts; Co-Pay up to $60Lasik15% Discount (varies by location)15% Discount (varies by location)Frequency:ExamLenses Contact Lenses (in lieu of glasses)Frames 12 Months24 Months24 Months24 Months12 Months12 Months12 Months24 MonthsWe are staying with VSP for vision benefits! Vision PremiumsPer MonthEmployee Contribution
LOW PLAN
HIGH PLAN
Employee Only
$8.09
$9.49
Employee + Dependents
$22.87
$26.82
Slide22LIFE & DISABILITY BENEFITS: ONE AMERICA
Short Term Disability: 100% Employer Paid
Weekly benefit of
70% income
up to
$1,000 for FT Hourly Staff, and $1,250 for FT Administrative Staff
Elimination
period: 7
th
day for illness & accident
Benefit Duration:
25 weeks
LTD: 100%
Employer
Paid
Monthly benefit of
60% income up
to
$6,000
Benefits begin on the
181st day. Maximum Duration: Up to Social Security Normal Retirement AgePre-existing Condition: 3 months / 12 monthsBasic Life and AD&D: 100% Employer PaidALL Full-time employees, two times salary up to a maximum of $150,000AD&D is 3 times salary, up to a maximum of $400,000Voluntary Life: 100% Employee PaidEmployee can elect a minimum of $10,000 up to $500,000 (not to exceed five times annual base salary) in increments of $1,000 with a Guarantee Issue of $150,000. Spouse is eligible for coverage if employee elects voluntary life. Spouse can elect a minimum of $10,000 up to $2500,000 and cannot exceed 100% of employee election. Guarantee Issue of $20,000. Employee can elect child life coverage up to a $10,000 benefit. Child Life up to age 19, or 25 if a full time student.
Slide23WHAT YOU NEED TO DO:
Complete Enrollment
on ADP at
https://workforcenow.adp.com
by May 18
th
.
Attend HDHP/HSA sessions
at
Beeghly
Library, Bayley Room on
April 30
th
(12-1:30pm), May 3
rd
(4-5pm, 5-6pm) if you would like more information
If electing voluntary life for the first time or making any changes in coverage (adding dependents, etc.), you will have to fill out an Evidence of Insurability Form (EOI)
Slide24WHAT YOU NEED TO DO:
Need Assistance? Carrier Websites and Customer Service Number
If you need personal assistance with benefits, contact:
Scott Simon / Elizabeth Foos
HR Department: 740-368-3394 / 740-368-3327
Email:
slsimon@owu.edu
/
ekfoos@owu.edu
Medical Benefits & Dental – Anthem Blue Cross & Blue
Shield
Manage your medical and dental benefits at
www.anthem.com
Customer Service: 800-552-9159
Coverage while traveling: 800-810-2583 (800-810-BLUE)
Anthem will issue personalized ID cards when you enroll for coverage.
You can request replacement cards or print a temporary ID at
www.anthem.com
.Vision Benefits – VSPManage your vision benefits at www.vsp.com Customer Service: 1-800-877-7195Life & STD/ LTD Benefits – Anthem LifeManage your ancillary benefits at https://www.oneamerica.com/ Customer Service: 1-800-249-6269Broker for all lines of coverage – McGohan BrabenderIf you need additional claims assistance, you can contact the Customer Care Team at: Phone: 937.260.4300 or 877.635.5372Fax: 937.499.1160, Email: customerservice@mcgohanbrabender.com
Slide25Questions?