• Save
Chandler 2013 open enrollment presentation with voice 2
Upcoming SlideShare
Loading in...5
×
 

Chandler 2013 open enrollment presentation with voice 2

on

  • 344 views

 

Statistics

Views

Total Views
344
Views on SlideShare
344
Embed Views
0

Actions

Likes
1
Downloads
0
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment
  • During this presentation we will cover:Healthcare Reform UpdatesMedical options we will continue to offer as well as any changes for the new plan yearVoluntary benefits available to employees to purchaseAnd the UHC tools and Resources available to UHC members.
  • In addition to the new contraceptive benefit, lactation support and counseling as well as costs for renting breast-feeding equipment for each child’s birth are covered at no cost-share. In addition to covering the cost of rental, UnitedHealthcare will also cover the purchase of a personal, double-electric breast pump at no cost to the member.  For quality products, easy accessibility, convenience and portability, UnitedHealthcare believes some members may prefer to purchase a breast pump rather than rent hospital-grade equipment. Additionally, we believe purchasing a personal breast pump is on average less expensive than renting a hospital-grade breast pump. To rent or purchase breast pumps, members will be required to contact UnitedHealthcare or a network physician, hospital or durable medical equipment (DME) supplier. The physician, hospital or DME supplier will bill UnitedHealthcare directly for reimbursement. Members will not be able to purchase supplies, such as breast pumps, at retail and send the receipt for reimbursement.Here is the list of network DME suppliers we have contracted with. The list is subject to change. Members may call the phone number on the back of their health plan ID card for the list of DME suppliers.
  • For the 2013-14 plan yearCUSD will continue to offer the traditional Choice Plus PPO Plan as well as two high deductible health plans: The HDHP1500 and the HDHP2700 both paired with a health savings account.
  • The next 2 options available are high deductible health plans known as HDHP plans. In the next few slides we will cover how these plans differ from the traditional PPO plan as well the benefit of enrolling in a high deductible health plan paired with a health savings account.
  • High deductible health plans are consumer driven plans which provide you more control over your health care cost.The premiums for high deductible health plans are typically half the cost of a traditional PPO plan.Since the premiums are significantly lower, these plans are paired with a health savings account, which the district funds to assist you in paying for your medical expenses. If you have no medical expenses then the money remains in your account for future use. In addition to lower premiums it also offers you a piece of mind in the event something catastrophic occurs. These plans have a maximum out of pocket which is the most you will pay during one plan year. Let’s take a look at the how these plans works.
  • The IRS determines how much you can contribute every year. In 2013, individuals can contribute up to $3,250 and families can contribute up to $6,450 In 2012. Keep in mind that what CUSD contributes also count towards this maximum.As a bonus, those 55 years or older can fund up to $1,000 a year as a “catch-up” contribution to help prepare for your health care costs in retirement. If you and your spouse are both 55 or older, you can both contribute an additional $1,000 – please reference irs.gov for more details about contributing two catch-up contributions in the same family.While there is a limit on how much you can deposit into your HSA each year, there is no limit on how much you can save in your HSA over the long term.
  • You can use the money in your HSA to pay for “eligible medical expenses” permitted under federal tax law. That includes medical, dental and vision care and services, as well as prescription drugs, including costs that apply to your medical plan deductibles, as well as the coinsurance you pay under the plan. The HSA is a great way to pay for those out of pocket costs.You may be surprised to know that you can apply your HSA dollars to a wide variety of expenses, including acupuncture, contact lenses, LASIK surgery, dental surgery and braces, even hearing aids. A detailed list ofeligibleandnon-eligible medicalexpenses is available to you at irs.gov. Remember, if you use your HSA money to pay or reimburse for “eligible medical expenses,” the money taken out of the account is incometax-free.In addition to using your HSA dollars for your own medical expenses, you can also use them to pay for eligible medical expenses for your spouse or dependents, even if they are notcovered by your health plan.
  • You may be wondering what health-related items you can’t pay for with your HSA funds. Generally, you cannot use the money to pay for medical insurance premiums. But, there are exceptions. You can use HSA funds to pay for:Any health plan coverage while receiving federal or state unemployment benefits,COBRA health insurance continuation coverage after leaving employment with a company,eligible long-term care, andMedicare premiums and out-of-pocket expenses, including deductibles, co-pays, and co-insurance for Medicare Parts A, B, C and D.
  • Before we conclude, let’s review some common questions.How do I enroll in the HSA Plan?Enroll during your Open Enrollment period (if you qualify) Check your employer benefit information for details Can I take the funds in my HSA with me if I leave the company?You keep it. You don’t even have to change banks. If you leave your job, change health plans or retire, you can still use your HSA to pay for qualified medical expenses. However, IRS rules will not allow you to deposit money into the HSA and receive tax benefits if you are not currently enrolled in an HSA-eligible health plan. Can I add my own contributions to my HRA?Yes. Anyone can contribute to your HSA. Keep in mind that annual contribution limits above what is allowed are subject to income taxes and a 20% penalty.How do I access my account?When you receive a bill from your doctor or if you are at the pharmacy filling a prescription, you have a few options. • First, most banks will give you a debit card to make paying easy. You can pay the bill with your debit card by filling out the credit/debit card information on the bill. If you are at the pharmacy or a walk-in clinic, you can swipe the card or hand it to the cashier, just like you would with any other debit card.• Some banks may also make checks available to you (sometimes at a charge).• You can pay another way, such as with cash or other credit card. Later, you can choose to reimburse yourself from your HSA. Or, let your dollars grow for the future.You also can manage your account by:Contacting a customer care professional. Accessing your account online through myuhc.com
  • Under the Core Plan, when you visit a Delta Dental provider, preventive services are covered at 100%. Basic services such as fillings, with the exception of sealants, are covered at 70%; major services including root canals and crowns are covered at 40% after a six month waiting period; orthodontics and surgical extractions such as removal of impacted wisdom teeth are not covered. The Core Plan pays a maximum benefit of $1,500 per year for covered services in addition to your preventative services.. Under the Premier Plan, when you visit a Delta Dental provider, preventive services are covered at 100%. Basic services are covered at 80%; major services are covered at 50% including surgical removal with no waiting period; and the plan pays up to $1,000 per lifetime for orthodontia per person. The Premier Plan pays a maximum benefit of $1,500 per year for covered services. The Delta Dental plans allow you to visit any dentist or specialist without a referral. The coverage levels provided will typically be higher when you visit a Delta Dental network provider. If you choose to visit a non-participating provider, Delta Dental will still provide benefits, but at reduced levels. The coverage levels you see here are applied when you visit a Delta Dental provider.Prices are as follows: For employee with 22 deduction of the core plan plan:For employees with 19 deductions the rates are as follows:Rates for the premier plan are as follows: Employee with 22 deductionsEmployees with 19 deductions:
  • If you are looking for a dental plan to cover preventative services but also want to have coverage juuust in case something happens, but don’t want the high premiums. Then you may want to consider a dental policy through TDA Total Dental Administrators. The policy covers.Preventative Services at 100%All other services such as fillings, crowns and root canals have a predetermined set feeThere are no annual or lifetime benefit maximums, so you can have $5,000 worth of dental work in one year if you needed.It provides orthodontic servicesAnd premiums are affordable whether it’s employee only or family coverage you are looking forSimilar to an HMO a dentist must be designated and services are only available in the state of Arizona.
  • Under the VSP plan, you may visit any vision care provider. However, benefits are provided at significantly higher levels when you visit a VSP network doctor.For example, when you visit a VSP provider, you pay a $10 copay for your vision exam, and the plan pays the balance. Out-of-network the plan pays just $35 for your visit and you will pay the balance.Refer to your Benefit Guide for a more detailed summary of the benefits provided under the voluntary vision plan. And visit the VSP web site at vsp.com to find a VSP network provider.If you choose to enroll in VSP please note that VSP does not provide insurance cards. Providers are able to verify coverage by name and date of birth.

Chandler 2013 open enrollment presentation with voice 2 Chandler 2013 open enrollment presentation with voice 2 Presentation Transcript

  • Chandler Unified School DistrictYour 2013-2014 UnitedHealthcare Plan Benefits
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.2ReminderOpen EnrollmentApril 22nd to May 10th
  • 3Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.What We Will Cover Today•Healthcare Reform Updates•Medical Plan options & changes•How medical plans work•Voluntary Benefits employees canpurchase
  • Note: Condoms and spermicidalagents, are not covered underthe health care reform lawbecause they are availablewithout a prescription. Inaddition, the law only coverswomen’s contraception, so malecontraception and sterilizationare not included in thepreventive care benefits.UnitedHealthcare will cover tier-1 contraceptive methods forwomen without cost-share:* Hormonal methods* Emergency contraceptionThe following Devices will be covered under the medicalbenefit, when provided by a network physician, facility orhealth care professional:•Intrauterine devices (IUD)•Diaphragms•Sterilization procedures for women, such as tuballigationsContraceptive Benefit - All PlansChanges Effective July 1st
  • 5Confidential Property of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.Breastfeeding Support – All PlansBreastfeeding Equipment costs and Lactationsupport and counseling are covered at 100%through a network physician, hospital or durablemedical equipment provider (DME)•Applies to lactation support by atrained provider•During pregnancy and/or in the postpartumperiodNote: Members will not be able to purchase supplies at retailstores and send in the receipt for reimbursement. Please callCustomer Service number on back of card for instructions.Changes Effective July 1st
  • Medical Option• Choice Plus PPO Plan• HDHP1500• HDHP27006Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.7Changes to the Choice Plus PPO No changes to the deductible or out of pocket maximums Decreased rates FAQ availableUnited Health Care – Choice Plus PPONumber ofDeductionsEmployeeOnlyEmployee+Spouse Employee+Child(ren) Employee+Family Spousal Share22 $95.00/pay $490.35/pay $457.40/pay $720.97/pay $486.51/pay19 $110/pay $567.77/pay $529.62/pay $834.80/pay $563.33/pay
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.8Changes to the HDHP 1500 No change to the deductible of out of pocket maximums Change to HSA contribution: Contribution will be $548 for thefiscal year. First half of $274 deposited in August Final half of $274 deposited in JanuaryUnited Health Care – HDHP1500Number ofDeductionsEmployeeOnlyEmployee+Spouse Employee+Child(ren) Employee+Family Spousal Share22 $0.00 $251.48/pay $230.52/pay $398.17/pay $188.61/pay19 0.00 $291.18/pay $266.92/pay $389.61/pay $218.39/pay
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.9Changes to the HDHP 2700 No changes to deductible or maximum out of pocket. Change to HSA contribution: New HSA contribution willbe $1,262. First half of $631 deposited in August Final half of $631 deposited in JanuaryUnited Health Care – HDHP2700Number ofDeductionsEmployeeOnlyEmployee+Spouse Employee+Child(ren) Employee+Family Spousal Share22 $0.00 $212.51/pay $194.80pay $336.48/pay $159.39/pay19 0.00 $246.07/pay $225.56/pay $389.61/pay $184.55/pay
  • 10Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.Your Medical Benefits at a GlanceChoice Plus PPO PlanType of coverage Network benefit Non-network benefitPhysician’s office services$25 co-payment 50% after deductibleSpecialist office visit $50 co-payment 50% after deductibleUrgent care center services $50 co-payment50% after deductibleEmergency room services $500 co-payment $500 co-paymentInpatient hospital stay20% after $1,000individual deductible,$2000 family deductible50% after $2,000 individualdeductible, $4000 familydeductibleOut of Pocket Maximum$2,000 per individual,$4,000 family per PlanYear. (Deductibles andcopays do not apply)$6,000 per individual,$12,000 family per Plan Year(Deductibles and copays donot apply)
  • 11Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.Choice Plus PPO PlanPharmacy CostsRetail Mail orderTier 1$10 Member Cost1-Month Supply$25 Member Cost3-Month SupplyTier 2$35 Member Cost1-Month Supply$87.50 Member Cost3-Month SupplyTier 3$50 Member Cost1-Month Supply$125 Member Cost3-Month SupplyMembers are subject to $100 individual pharmacy deductible before copayment’sapply.LowestCostHighestCost
  • High Deductible Health Plans(HDHP)12
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.13High Deductible Health Plans(HDHP)• Consumer Driven Health• Half the cost of a traditional PPO• Help you save for future medical expenses• Protects from catastrophic medical expenses
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.14*From www.healthcarelane.comHow the HDHP Works
  • 15Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.Your Medical Benefits at a GlanceHDHP 1500 – Non-Embedded Plan*Type of coverage Network benefit Non-network benefitPhysician’s office services20% after deductible 50% after deductibleSpecialist office visit 20% after deductible 50% after deductibleUrgent care center services 20% after deductible50% after deductibleEmergency room services 20% after deductible 20% after deductibleInpatient hospital stay20% after $1,500 singledeductible, $3,000 familydeductible* (single deductibledoes not apply for families)50% after $3,000 singledeductible, $5,600 familydeductible* (single deductibledoes not apply for families)Out of Pocket Maximum(single max does not applyto families)$3,900 single, $7,800 forfamily coverage per Plan Year(Deductibles and copaysapply)$7,800 single, $15,200 forfamily coverage per Plan Year(Deductibles and copaysapply)
  • 16Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.Your Medical Benefits at a GlanceHDHP 2700 – Embedded Plan*Type of coverage Network benefit Non-network benefitPhysician’s office services20% after deductible 50% after deductibleSpecialist office visit 20% after deductible 50% after deductibleUrgent care center services 20% after deductible50% after deductibleEmergency room services 20% after deductible 20% after deductibleInpatient hospital stay20% after $2,700individual, $5,400family deductible perPlan Year (Individualdeductible applies foreach family member)50% after $5,400individual, $10,400 familydeductible per Plan Year(Individual deductibleapplies for each familymember)Out of Pocket Maximum$4,650 per individual,$9,300 for family perPlan Year. (Deductiblesand copays apply)$9,300 per individual,$18,200 for family per PlanYear. (Deductibles andcopays apply)
  • 17Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.HDHP Plan Pharmacy CostsRetail Mail orderTier 1$10 Member Cost1-Month Supply$25 Member Cost3-Month SupplyTier 2$30 Member Cost1-Month Supply$75 Member Cost3-Month SupplyTier 3$50 Member Cost1-Month Supply$125 Member Cost3-Month SupplyMembers are subject to their Medical/Pharmacy deductible before copay’s apply.Medications listed on Preventative Drug List are subject to copays.LowestCostHighestCost
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.18You are eligible to open an HSA if:• You are not covered by any other non-high deductible health plan,such as a spouse’s plan• You are not enrolled in Medicare• You do not receive health benefits under TRICARE• You have not received Veterans Administration (VA) benefitswithin the past three months• You cannot be covered by a health care FSA or HRAHSA eligibility requirements
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.19Annual HSA contribution limitsAmount ofFundingContributions above the annual limit aresubject to income taxes and a 20%penalty.AnnualContributionRules2013: $3,250 for individuals & $6,450 forfamiliesAdditionalFundingThose 55 years of age or higher, but notentitled to Medicare benefits, can fund anadditional $1,000/year “catch-up”contribution!Annual contribution limits are set by the IRS
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.20How you can use the HSAUse HSAdollars to payfor qualifiedmedicalexpenses foryour spouse ordependentsPharmacy,dental, visioncare servicesMedical plandeductibles andcoinsuranceAny money you take out of your HSA foreligible medical expenses is federal income-tax free
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.21How you can use the HSA1Coverage whilereceivingunemploymentbenefits2COBRAcontinuationcoverage3Eligible long-term care4Medicarepremiums andout-of-pocketexpensesOther qualified expenses
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.22TIP: Use your HSA to help you pay qualified expensesPresent ID card tonetwork doctorDoctor sendsclaim toUnitedHealthcareUnitedHealthcareapplies networkdiscount andnotifies doctor ofamount you mayowe.When you haveclaim activity,you will receive aEOB.Doctor bills youfor payment1. You can useyour HSA to pay2. Or you canchoose to payanother way (cash,credit card) andreimburse yourselflaterHow the HSA Plan WorksHSA Payment Process
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.23Common HSA Questions• Enroll during your Open Enrollment period• Check your employer benefit information fordetailsHow do I enroll?1Can I take the funds in my HSAwith me if I leave the company?2Can others contribute to myHSA?3How do I access the funds inmy account?4Yes. Funds belong to you even if you leaveyour job, change health plans or retire.Yes. Anyone can contribute to your HSA.Keep in mind that annual contribution limitsabove what is allowed are subject to incometaxes and a penalty.• Use your HSA debit card• Pay by check, cash or credit card andreimburse yourself later from your HSA
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.24OptumHealthSM Bank, Member FDICUnitedHealthcare’s health care bank of choice• FDIC-insured so you know your money issafe• Dedicated to helping people save for healthcare• One of the nation’s leading HSA custodians• Offers a Health Savings Account DebitMasterCard®• Account holders will receive Health SavingsNews e-newsletterOnly OptumHealthBank offers theconvenience ofHSA bankingthroughmyuhc.comPay billsMake depositsReimburse yourselfTrack spendingSee your tax savingsAnd more
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.252013-2014CUSD Voluntary Benefits
  • 26Voluntary Delta Dental Plan•All employees who work 20 hours or more per week areeligible to enroll in dental benefits.3 Dental Plans Offered• Premier Delta Dental Plan• Core Delta Dental Plan• (New) Total Dental Administrators(TDA)
  • Voluntary DentalCore PlanNo Orthodontics6 month waiting periodPreventative 100%Basic Services - 70%Excludes sealantsMajor Services - 40%Calendar Year Max - $1500Number ofDeductionsDentalPlanEmployeeOnlyEmployee+ SpouseEmployee+Child(ren) Employee+Family22 Core $17.36/Pay $33.79/pay $38.49/Pay $62.90/Pay19 Core $20.10/Pay $39.12/Pay $44.57/Pay $72.83/Pay22 Premier $24.05/Pay $47.50/Pay $55.13/Pay $92.28/Pay19 Premier $27.85/Pay $55.00/Pay $64.99/Pay $106.85/PayPremier PlanOrthodonticsLifetime Max - $1000 (Increased)Preventative - 100%Basic Services - 80%Includes sealantsMajor Services - 50%Calendar Year Max - $1500
  • Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.28Total Dental AdministratorsHealth Plan, Inc. (TDA)• Preventative Care Services are covered at 100%• All other services have a predetermined set fee.• No annual or lifetime benefit maximums• Orthodontics for Children and Adults are provided• Affordable premiums• Dentist Provider must be designated• Services are only available in the State of Arizona.
  • Vision - VSPCovers eye exams once every year.Lenses are covered 100% after a $20 co-pay.Frame allowance $130.Contacts in lieu of lenses and frames allowance $130.Premium based on 22 or 19 payroll deductions.Number ofDeductionsEmployeeOnlyEmployee+1 Employee+2 ormore22 $4.28/pay $6.21/pay $11.14/pay19 $4.96/pay $7.19/pay $12.90/pay
  • 30ING Life Insurance• New Insurance Carrier• Basic life insurance provided to all benefit eligible employees in theamount of $50,000• Additional voluntary life insurance coverage available to purchase,premiums based on age and amount of coverage• Spouse/child coverage available• If you are not currently enrolled in voluntary life insurance coverage butwish to enroll now, during this open enrollment period only. ING willguarantee coverage up to $150,000 for all employees without evidence ofinsurability.• Spouses are guaranteed up to $30,000 with no evidence of insurability• Children are guaranteed up to $10,000 with no evidence of insurability
  • 31AssurantShort Term Disability• During this open enrollment period only all employees can purchase shortterm disability coverage based on their salary not to exceed 66 2/3.Coverage amounts up to $3,000 are guaranteed with no evidence ofinsurability.• The policy does not pay for disabilities within 12 months of your initialenrollment plan, if you received medical treatment, consultation, care orservices (including diagnostic measures), or took prescribed drugs ormedicines for the disabling condition during the 12 months prior to yourinitial enrollment date.• To be eligible during pregnancy, you cannot be pregnant prior to thebenefit effective date.• The plan provides monthly benefits ranging from $360 to $5,000, basedon your annual salary, not to exceed 66 2/3% of your salary.
  • 32BASICFlexible Spending Accounts• An election must be made every year if you wish to enroll in a FlexPlan• Medical Flexible Spending account limit for 2013-14 plan year is$2,500• Dependent Care Flexible Spending account limit will remain at$5,000 maximum.• If you are enrolled in an HSA plan you are only able to use yourmedical flex spending account for dental and vision expenses• When making flex account elections please keep in mind that ifyou do not use the funds by June 30, 2014 you will forfeit allremaining money in the account
  • Long Term Care•Monthly Benefit to assist with nursing home expenses or in homelicensed care.•District Policy was $2,000 per month not to exceed $48,000 policy•No longer offered•If you wish to continue with the coverage you will need to downloadthe continuation of coverage form at:www.cusd80/continueltc.com• Mail directly to UNUM• You will have 60 days from June 30th to send in your form to portyour service.
  • Thank you!!!