April 23rd th through May 24 th For vision medical andor dental you will remain in the same plan and network for the 20192020 plan year if you dont do anything Open Enrollment elections cannot be made after ID: 783860
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Slide1
Open Enrollment 2019
Slide2Open EnrollmentApril 23rd
th
through
May 24
th
For vision
, medical, and/or
dental, you will
remain in the same plan and network for the
2019-2020 plan year if you don’t do anything
Open Enrollment elections cannot be made after
May 24
th
All changes take effect on July 1
st
Slide3Enrollment ChangesYou must reenroll in the FSA (health or dependent care)
Enroll
or
change your
medical and dental
Add
or remove
dependents
Enroll
in a Health Savings Account (HSA) – new enrollees only. If you are already enrolled, no action is
needed
Enroll or increase coverage for Life Insurance and Accidental Death & Dismemberment
Slide4What’s new for 2019-2020HSA/FSA yearly maximums increased.
HSA Individual $3,500
HSA Family $7,000
FSA health
$2,700
FSA/HSA admin fees will be paid for by the college
Up front college contribution to the HSA (July 22nd paycheck)
$1200 for single
$1600 for 2 party/family
Slide5What’s new for2019-2020 (continued)Medical Copay Decreases
Office visits will now be $25
Urgent Care will now be $35
Specialist will now be $
35
No change in
premiums for medical or dental
Slide6Eye ExamReminder
One
annual eye exam per person will
only
be covered under the vision plan through EMI Health
Injuries to eye(s) will still be covered under your medical
plan
Free to enroll/add dependents on your vision plan
Slide7Open LabsMay 9 Redwood Library Room 266 from
10:00 am– 1:00 pm
May 17 Redwood
Library Room 266 from
1:00 pm
–
4:00 pm
Slide8The college will do a one-time contribution$1200 for single coverage$1600 for 2 party or family coverage. On the July 1-15 (July 22nd) paycheck.
HSA Contribution
Slide9Healthcare HSATax Savings on ALL expenses related to medical, dental, & vision careFunds can be used as they are deposited
Funds rollover each year so you can use your HSA to save tax-free money for retirement
Flexibility in funding
Can enroll whenever you become eligible
Health Savings Accounts: Increase Your Spending Power
Slide10An employee who is:Covered by a High-Deductible Health Plan (HDHP)Not enrolled in Medicare nor MedicaidNot covered under other health insurance*(Includes TRICARE and receipt of VA or IHS benefits within the previous 3 months) (Can be under a spouse’s HDHP)
Not another person’s tax dependent
Who is Eligible for an HSA?
Slide11You and your spouseAny dependent claimed or eligible to be claimed on your tax return (defined by IRC Section 152)Dependents defined different for health insurance and HSAs:HSA funds cannot be used for medical expenses incurred by a child who is not eligible to be claimed as a dependent on your tax returnDependents ineligible for HSA reimbursement can still be covered on your HDHP
Whose expenses can your HSA cover?
Slide12FSA & HSA ExpensesQualified
Doctor and hospital visits
Medical equipment
Chiropractic Care
Dental care
Vision care
Medications
The penalty for using HSA funds for unqualified expenses is 20% + taxes. Keep all itemized receipts in case of an IRS audit
Not Considered “Qualified”
Insurance premiums (other than Medicare and some less common insurance types for the HSA)
Over-the-counter drugs without a prescription (insulin is an exception)
Cosmetic procedures
Expenses covered by another insurance plan
General health items
Slide13HSA vs FSAHSA
Funds are available as they are deposited
Must be covered by HDHP
No adjudication required
No use-it-or-lose-it
FSA
Funds available on July 1st
Medical coverage does not matter
Adjudication required on all expenses
Unused funds are forfeited at plan year end
Slide14Debit CardIf you already have a debit card from last year:FSA funds will be loaded onto the card on July 1st.HSA funds will be available as deposited
Slide15Flexible Spending Accounts – Increase Your Spending PowerHealthcare FSA
Tax Savings on ALL expenses related to medical, dental, & vision care
Maximum contribution limit is $2,700
Funds loaded to your NBS MasterCard on the 1st day of the plan year (plus manual reimbursement options are available too)
Dependent Care FSA
Tax savings on your day care/child care expenses
Maximum contribution limit is $5,000
Continual reimbursement is available plus many other convenient reimbursement options
Slide16NBS Online Enrollment Portalwww.mywealthcareonline.com/nbsbenefits
Slide17NBS Mobile AppWith the NBS mobile app, you can easily manage your benefits on-the-go!
View your account balances
See claim and reimbursement history
Submit claims
Attach documentation with your device’s camera
Set up account notifications and alerts
Report benefit card lost/stolen
Order new benefit cards
Quick contact to NBS
Available at the iTunes Store and Google Play Store
.
Slide18Medical & Dental BenefitsOpen Enrollment 2019-2020
Slide19DENTAL PROVIDERS1,275 GENERAL DENTISTS291 SPECIALISTS
OVER 100,000 ACCESS POINTS
NATIONWIDE
No Changes
Slide20DENTAL RATES 2019-2020Per Pay Employee Premium2019/20
Employee
$2.25
Two-Party
$3.75
Family
$5.95
No changes in premium
Slide21MEDICAL RATES 2019-2020Per Pay PeriodPAR
TRADITIONAL PLAN
HIGH DEDUCTIBLE PLAN
Employee
$63.00
$43.25
Two-Party
$138.00
$93.25
Family
$192.00
$134.50
PVC
TRADITIONAL PLAN
HIGH DEDUCTIBLE PLAN
Employee
$32.00
$14.00
Two-Party
$71.00
$32.00
Family
$97.00
$43.00
PFP
TRADITIONAL PLAN
HIGH DEDUCTIBLE PLAN
Employee
$7.50
$0
Two-Party
$17.00
$0
Family
$23.50
$0
No changes in premium
Slide22ONLINE ENROLLMENTClick the Regence Online Enrollment link on the HR website – April 23
rd
– May 24
th
If you already have an account, log in – this is a separate login from your Regence.com account
First time users “Create an Account”
Identify yourself and then create a User ID and Password
Begin open enrollment process
Online Enrollment Assistance
5 a.m. to 5 p.m.
855-216-8125
Slide23ONLINE ENROLLMENT -ScreenshotsSlide24ONLINE ENROLLMENTChanges to makeMaintain personal information
View important benefit information
Compare plans
Manage account information
Link to other benefit websites
Slide25NETWORK OPTIONSSlide26ParticipatingAll 50 hospitals12,885 providersIncludes Primary Children’s Hospital, Huntsman Cancer Institute, and University of Utah
All Urgent Cares including
InstaCares
and Kids Cares
Blue Card for National Access
Broadest Access
All Surgical Centers
Slide27ValueCare - PPO41 Hospitals12,709 ProvidersIncludes Primary Children’s Hospital, Huntsman Cancer Institute, and University of Utah
All Urgent Cares including
InstaCares
and Kids Cares
Blue Card for National Access
Broader Access
All Surgical Centers
Slide28Focal Point13 Hospitals6,889 ProvidersIncludes Primary Children’s Hospital, Huntsman Cancer Institute, and University of Utah
Blue Card for National Access
Includes the following counties:
Salt Lake
Utah
Davis
Weber
Tooele
Summit
Box Elder
Cache
Slide29Blue Network96% of Hospitals92% of PhysiciansBlue Cross Blue Shield Association, www.bcbs.com
Slide30Ambulatory Surgery CentersProcedure
Hospital Fee
ASC FEE
Difference
% Savings
ACL Reconstruction
$16,082
$8,800
($7,282)
83%
Knee Scope Lateral Release
$6,501
$3,150
($3,351)
106%
Total Hip Arthroplasty
$26,152
$17,500
($8,652)
49%
Shoulder Decompression
$10,022
$5,900
($4,122)
70%
Ulnar Nerve Transportation
$5,757
$3,300
($2,457)
74%
Colonoscopy
$1,472
$573
($899)
157%
Ear Tubes Bilateral
$1,513
$746
($767)
103%
All
but Cottonwood Surgical Center is contracted.
© 2018 Regence BlueCross BlueShield of Utah. All rights reserved. Private and confidential.
Slide31BENEFITSSlide32Medical Summary
Traditional Plan
Covered
Medical Services
In-network
Out-of-network
Deductible per plan year
$400
claimant
$800
family
$1,000 claimant
$2,000 family
Pharmacy deductible per plan year
$100 claimant
$300 family
Maximum
out-of-pocket per plan year
$3,200 claimant
$6,500 family
$5,000
claimant $10,000 per family
Pharmacy out-of-pocket per plan year
$2,000 claimant
$6,000 family
Accumulation from July 1, 2019 through June 30, 2020
-VSP direct for eye exams and materials.
-Injuries to the eye continue with Regence coverage.
Slide33Traditional PlanCovered Services
In-Network
Out-of-Network
Primary Care office
visit for illness/injury
$
25
40
%
AD
Specialist Care office
visit for illness/injury
$
35
40
%
AD
Other Practitioner Visit/Urgent Care office
visit for illness/injury
$
35
40
%
AD
Chiropractic
Care office visit for illness/injury
$35
40
%
AD
Preventive Care
(identified
by age and gender)
Covered at 100%
25%
AD
Imaging (CT/PET
Scans, MRI’s)
$
50
AD
$50 Copay/
visit and
40%
AD
Diagnostic,
Laboratory, Radiology
(includes lab and radiology performed during an office visit, an ER visit, in-patient, out-patient, minor and major)
20%
AD
40
%
AD
Emergency Room
20
%
AD
40
%
ADMDLive Teleheath$10 copayN/A
Balance billing applies for out-of-network
AD means after
deductible
Slide34Pharmacy Summary– Traditional Plan
Covered
Prescription Services
Covered
Prescription Services Cost
Deductible per plan year
$100 individual
/
$300
per family
Waived for Generics and Mail-order
Out-of-pocket
maximum per plan year
$2,00
0 individual / $6,000 family
RETAIL 30-DAY
SUPPLY – not more than a
30-day
supply
or 100 unit doses
RETAIL 30-DAY
SUPPLY – not more than a 30-day
supply or 100 unit doses Cost
Tier 1
(
Generic)
$7 deductible waived
Tier
2
(Brand
Name Preferred)
25% to a maximum of $150 per script
Tier 3
(
Brand Non-Preferred)
30% to a maximum of $175 per script
SPECIALTY MEDICATIONS – 30-DAY
SUPPLY
SPECIALTY MEDICATIONS – 30-DAY
SUPPLY Cost
Tier
4 (Generic
and
Brand Name Preferred)
10% to a maximum of $250 per script
Tier
5
(Brand
Non-Preferred)
15% to a maximum of $300 per
script
MAIL-ORDER 90-DAY SUPPLY
MAIL-ORDER 90-DAY SUPPLY Cost
Tier
1 (Generic
)
$7 deductible waived
Tier
2
(Brand
Name Preferred)
25% to
a maximum of $300 per 90-day supply
Tier 3
(
Brand Non-Preferred)
30% to
a maximum of $437.50 per 90-day supply
Slide35Medical Summary - High Deductible Health PlanIn-Network
Out-of-Network
Deductible
$1,500 single
$3,000 single
Deductible
$3,000 family
$6,000 family
Out-of-Pocket Max
$3,000 single
$6,000 single
Out-of-Pocket Max
$6,000 family
$12,000 family
Coinsurance
After deductible, you pay 10%
After deductible, you pay 30%*
Accumulation from July 1, 2019 through June 30, 2020
Balance billing applies for out-of-network
Slide36High Deductible Health PlanCovered Services
In-Network
Out-of-Network
Primary Care office
visit for illness/injury
$25
AD
30%
AD
Specialist Care office
visit for illness/injury
$35
AD
30%
AD
Other Practitioner Visit/Urgent Care office
visit for illness/injury
$35
AD
30%
AD
Chiropractic
Care office visit for illness/injury
10%
AD
30%
AD
Preventive Care
(identified
by age and gender)
Covered at 100%
30%
AD
Imaging (CT/PET
Scans, MRI’s)
$50
AD
$50 Copay/
visit and
30
%
AD
Diagnostic,
Laboratory, Radiology
(includes lab and radiology performed during an office visit, an ER visit, in-patient, out-patient, minor and major)
$25
AD
30%
AD
Emergency Room
10%
AD
30%
AD
MDLive
Teleheath
$42/visit for medical
$75/visit
mental health$10 copay when deductible is met30% ADBalance billing applies for out-of-networkAD means after
deductible
Slide37Pharmacy Summary – HighDeductible
Covered
Prescription Services
Covered
Prescription Services Cost
Deductible per plan year
Included in Medical deductible
Out-of-pocket
maximum per plan year
Included
in Medical out-of-pocket maximum
RETAIL 30-DAY
SUPPLY – not more than a
30-day
supply
or 100 unit doses
RETAIL 30-DAY
SUPPLY – not more than a 30-day
supply or 100 unit doses Cost
Tier 1
(
Generic)
$7
copay
Tier 2
(
Brand Name Preferred)
25% to a maximum of $150 per script
Tier 3
(
Brand Non-Preferred)
30% to a maximum of $175 per script
SPECIALTY MEDICATIONS – 30-DAY
SUPPLY
SPECIALTY MEDICATIONS – 30-DAY
SUPPLY Cost
Tier 4
(
Generic and
Brand
Name Preferred)
10% to a maximum of $250 per script
Tier 5
(
Brand
Non-Preferred)
15% to a maximum of $300 per
script
MAIL-ORDER 90-DAY SUPPLY
MAIL-ORDER 90-DAY SUPPLY Cost
Tier 1
(
Generic)
$7
copay
Tier
2
(Brand Name Preferred)
25% to
a maximum of $300 per 90-day supply
Tier 3
(
Brand Non-Preferred)
30% to
a maximum of $437.50 per 90-day supply
Medications on the Optimum Value list have their deductible waived
Slide38Optimum ValueValue-based medications(Usually Generic
)
Deductible waived on Qualified High Deductible Health Plan for medications used to prevent or manage chronic conditions:
Depression
Cardiovascular Disease
Diabetes
High Cholesterol
Osteoporosis
Asthma
Slide39PLAN COMPARISONTraditional Plan
HDHP
Annual
Premium
Family Coverage
$4,368 PAR
$2,232 PVC
$564 PFP
$2,988 PAR
$984 PVC
$0 PFP
Deductible
$400 per individual
$800 family
Pharmacy - $100/$300
$1,500 single
$3,000 family
Pharmacy – Subject to medical
deductible
Coinsurance
80/20%
90/10%
Out-of-Pocket
max (OOP)
$3,200 per individual
$6,500
family
Pharmacy - $2000/$6000
$3,000 single
$6,000 family
Pharmacy – subject
to medical OOP
SLCC Annual
HSA Contribution*
N/A
$1,200 for single enrollees
$1,600 for family enrollees*
*
The full HSA contribution will be front-loaded in July by SLCC
Slide40Example 1EXAMPLE
1 – SINGLE
Traditional
High Deductible
Example:
$2,000
in medical expenses
$2,000
in medical expenses
Individual Deductible/Coinsurance
Deductible: $400
20%
Coinsurance: $320
Member Total = $720
Deductible: $1,500
10%
Coinsurance: $50
Member Total = $1,550
2019-2020 HSA
Contribution
N/A
$1,200
Insurance Pays
($1,280)
($450)
HSA Pays
N/A
*($1,200)
Member Balance
$720
$350
Member Savings
N/A
$370
Annual Premium (Single
Coverage
Value Care)
$768
$336
Annual Premium Savings
N/A
$432
*SLCC will contribute $1,200 for the July 1-15 pay period into the employee’s HSA
Slide41Example 2EXAMPLE 2
Traditional
High Deductible
Example:
$35,000 in medical expenses
$35,000 in medical expenses
Individual Deductible/Coinsurance
Deductible:
$800
20% Coinsurance = $5,700
Member Total = $6,500
Deductible: $3,000
10% Coinsurance: $3,000
Member Total = $6,000
2019-2020 HSA
Contribution
N/A
$1,600
Insurance Pays
($28,500)
($29,000)
HSA Pays
N/A
($1,600)*
Member Balance
$6,500
$4,400
Member Savings
N/A
$2,100
Annual Premium
(Family
Coverage
Value Care)
$2,328
$1,032
Annual Premium Savings
N/A
$1,296
*SLCC will contribute $1,600 for the July 1-15 pay period into the employee’s HSA
Slide42Example 3EXAMPLE 3 – PHARMACY
Traditional
High Deductible
Example:
Humalog- Preferred Formulary
Medication
Humalog- Preferred Formulary
Medication
Pharmacy Deductible
$100 per individual
$300 per family
Subject to medical deductible
$1,500 single
$3,000 family
Average Cost of Medication
$543.94 per script
$543.94 per script
Patient Balance
Deductible: $100
25% Coinsurance = $110.99
Member
Total = $210.99
Deductible: waived
(Optimum Value Medication)
25% Coinsurance = $135.99
Member Total
= $135.99
SLCC Annual HSA Contribution
N/A
$1,200 (single) or $1,600 (family)
HSA Balance
N/A
$1,064.01 (single) or $1,464.01 (family)
*SLCC will contribute $1,600 for family or $1,200 for single coverage on the July 1-15 pay period into the employee’s HSA
Humalog = 100 Unit/ML = $543.94
Avg
Price
Slide43EMPLOYEE TOOLSSlide44Regence.comView account information and order or print replacement ID cards
Live chat with a customer service representative.
Easy access and alerts for new claims, EOBs, messages
See where you are at meeting your deductible and out-of-pocket maximum
Slide45Regence.com continuedOne-click access to telehealth through MDLIVE
Find a doctor and access cost estimators
Sign in to hubbub through Regence
Medical Supply shopping and repayment made easy
BabyWise
maternity program provides support to help you have a healthy, full-term baby
Advantages gives you discounts with many companies
Slide46Getting started at regence.comHave your Member ID card ready
Answer a series of security questions
Keep your login and password in a secure place
Select ‘Register’ and begin the guided registration process
Slide47Find a Doctor and estimate costs at regence.comSign-in for providers and estimates tailored to youSelect a category – doctor, place, estimate costs, treatment timelines and more
Refine results based on network coverage, accepting new patients, provider language, and more
Best coverage indicator provides insight to Category 1 providers.
These providers typically offer the best coverage based on benefit design for copays and coinsurance
Read reviews from members who have had an appointment with the doctor
Slide48Telehealth through MDLIVEGet care from anywhere, anytime
Phone or video visit with a doctor
More than
nurseline
– get treatment plan and Rx, if needed
Available for spouses and kids
24/7/365 on-demand or by appointment
Traditional PPO Plan $10 Copay
High Deductible Plan $42 for medical $75 mental health until deductible is met, then $10 copay
Register today at
MD Live
or by visiting your regence.com member dashboard
Slide49Telehealth through MDLIVECommon IssuesCommon Issues
Acne
Allergies
Asthma
Bronchitis
Cold & Flu
Fever
Headache
Infections
Joint Aches & Pains
Nausea & Vomiting
Pink Eye
Rashes
Sinus Infection
Sore Throat
Sunburn
Urinary Tract Infection
Pediatrics
Cold & Flu
Constipation
Earache
Fever
Nausea & Vomiting
Pink Eye
Sinus Infection
Register and be entered to win a prize
Register today at
MD Live
or by visiting your regence.com member dashboard
Slide50BabyWise education and toolsGet regular updates about what to expect during pregnancy and prenatal appointments
Access to a nurse by telephone 24/7
Regular contact from an assigned nurse (if high-risk)
Expert information about nutrition, breastfeeding and common pregnancy concerns
Access to
Due Date Plus
app to help track every step
Call 1-888-JOY-BABY (569-2229) to get started!
Slide51Medical supply shopping and repayment made easyVisit regence.com Medical Supplies page to connect with retailers to buy crutches, breast pumps, CPAP supplies and more
Online shopping is convenient, saves time and may offer discounts
Get repaid for your covered portion using an easy online claims form
Learn more at: regence.com/
MedicalSupplies
Slide52Regence mobile appEasily register for regence.com
Access member ID card
Check benefits and coverage
View claims and EOBs
Search for in-network doctors, specialist or clinic
Estimate out-of-pocket costs
Learn more at: regence.com/mobile
Slide53Livongo