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  1. 1. 2009-2010 STATE OPEN ENROLLMENT
  2. 2. Agenda <ul><li>Mandatory Open Enrollment </li></ul><ul><li>Dependent Eligibility and Reporting Changes </li></ul><ul><li>Cost-sharing Changes </li></ul><ul><li>Coverage Changes </li></ul><ul><li>Employee Benefits Communications </li></ul><ul><ul><li>Guide </li></ul></ul><ul><ul><li>Benefits Open Enrollment website </li></ul></ul><ul><ul><li>Expo and Information Meetings </li></ul></ul><ul><ul><li>Contact Information </li></ul></ul>
  3. 3. 2009–2010 ADOA Open Enrollment <ul><li>Thursday, Aug. 20 – Friday, Sept. 4 at 5 PM </li></ul><ul><li>All employees must re-enroll – If not, will be randomly defaulted into medical EPO </li></ul><ul><li>Changes effective Oct 1 st </li></ul><ul><li>Rates effective with Oct 9 th paycheck </li></ul><ul><li>Plans: medical, dental, vision, short-term disability, supplemental life and dependent life (not Aetna). </li></ul>
  4. 4. 2009-2010 Open Enrollment <ul><li>Highlights of 2009-2010 Open Enrollment </li></ul><ul><ul><li>Cost-sharing </li></ul></ul><ul><ul><li>New Coverage Tier </li></ul></ul><ul><ul><li>Elimination/reduction of some benefits </li></ul></ul><ul><ul><li>New Plan Design </li></ul></ul><ul><ul><li>New Vendors </li></ul></ul><ul><ul><li>We’re learning with you! </li></ul></ul>
  5. 5. Cost Sharing Changes <ul><li>Monthly Medical and Dental Rates Increase </li></ul><ul><ul><li>New Medical 4-tier Rate Structure - ( for single; emp + 1 child; emp + 1 adult; family ) to align premiums with costs </li></ul></ul><ul><ul><li>Moderate to significant rate increases for EPO and PPO participants </li></ul></ul><ul><ul><li>New Vision 3-tier Rate Structure as Dental </li></ul></ul><ul><ul><li>Same employer contribution for both Dental Plans </li></ul></ul><ul><li>Higher Out-of- Pocket Costs </li></ul><ul><ul><li>Higher co-payments in EPO </li></ul></ul><ul><ul><li>Higher coinsurance and deductibles in PPO </li></ul></ul><ul><ul><li>New HSA Option with HealthFund HSA for out-of-pocket costs </li></ul></ul>
  6. 6. 2009-2010 Health Plan Changes <ul><li>New Pharmacy Benefits Vendor: MedImpact </li></ul><ul><li>New EPO/PPO Medical Networks: Aetna, AmeriBen, CIGNA & UHC </li></ul><ul><ul><li>Statewide & National Coverage – eligibility no longer based on Home Address </li></ul></ul><ul><ul><li>Transition of Care – Details available on website </li></ul></ul><ul><ul><li>International – EPO/HSA (Emergency & Urgent Care Only; PPO (Emergency & Urgent Care at In-Network Benefit Level) </li></ul></ul>
  7. 7. Health Plan Cont’d EPO Per Pay PPO Per Pay HSA Per Pay Employee $18.00 $71.08 $11.54 EMP + Adult $44.77 $151.38 $36.92 EMP + Child $36.46 $142.62 $27.23 Family $82.15 $204.46 $69.23
  8. 8. Coverage Changes <ul><li>Prescription Drugs </li></ul><ul><ul><li>“ Dispense as Written” Brand Name (if generic available) must pay copayment plus difference in cost between brand and generic </li></ul></ul><ul><ul><li>Limited to meds that do not have equally effective over-the-counter substitute </li></ul></ul><ul><ul><li>Existing active prescriptions will continue </li></ul></ul><ul><li>Home Health limited to 168 hours per plan year </li></ul><ul><li>Bariatric Surgery covered if 35+ body mass index plus two or more medical conditions: </li></ul><ul><ul><li>Type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers </li></ul></ul>
  9. 9. Coverage Changes <ul><li>Co-pays/Deductibles </li></ul><ul><li>EPO – No Deductible </li></ul><ul><li>PCP $15 </li></ul><ul><li>Specialist $30 </li></ul><ul><li>Preventative $15 </li></ul><ul><li>OB/GYN $10 </li></ul>
  10. 10. Coverage Changes PPO – Must Meet Deductible First Deductible: In-Network: Individual $500 Family $1,000 Out-of-Network Individual $1,000 Family $2,000 Co-pays: In-Network: PCP $15 Specialist $30 Preventative $15 OB/GYN $10 Out-of-Network: 50% Subject to Deductible
  11. 11. Coverage Changes <ul><li>EPO </li></ul><ul><li>Outpatient Services $50 </li></ul><ul><li>Emergency </li></ul><ul><ul><li>Ambulance $ 0 </li></ul></ul><ul><ul><li>ER $125 </li></ul></ul><ul><ul><li>Urgent Care $40 </li></ul></ul><ul><ul><li>Hospital Admission $150 </li></ul></ul><ul><ul><li>Maternity Admission $250 </li></ul></ul><ul><ul><li>Per baby </li></ul></ul>
  12. 12. Coverage Changes <ul><li>PPO – In-Network </li></ul><ul><li>Outpatient Services $50 </li></ul><ul><li>Emergency </li></ul><ul><ul><li>Ambulance $ 0 </li></ul></ul><ul><ul><li>ER $125 </li></ul></ul><ul><ul><li>Urgent Care $40 </li></ul></ul><ul><ul><li>Hospital Admission $150 </li></ul></ul><ul><ul><li>Maternity Admission $250 </li></ul></ul><ul><ul><li>Per baby </li></ul></ul><ul><li>PPO – Out-of-Network </li></ul><ul><li>Outpatient Services 50% </li></ul><ul><li>Emergency </li></ul><ul><ul><li>Ambulance – Amount above In-Network Rate </li></ul></ul><ul><ul><li>ER $125 </li></ul></ul><ul><ul><li>Urgent Care 50% </li></ul></ul><ul><ul><li>Hospital Admission 50% </li></ul></ul><ul><ul><li>Maternity Admission 50% </li></ul></ul>
  13. 13. Coverage Changes <ul><li>Services no longer covered: </li></ul><ul><ul><li>Cosmetic Surgery Complications </li></ul></ul><ul><ul><li>Erectile Implants </li></ul></ul><ul><ul><li>Infertility Services </li></ul></ul><ul><ul><li>Surrogacy </li></ul></ul><ul><ul><li>TMJ Surgery </li></ul></ul>
  14. 14. Health Plan Changes cont’d <ul><li>Avesis renewed, but will also provide a discount card to employees who waive vision insurance </li></ul><ul><li>Dental contract was not subject to renewal </li></ul><ul><li>Introduction of Health Savings Account Option </li></ul>
  15. 15. What is an HSA? <ul><li>Health Savings Account (HSA) Option </li></ul><ul><ul><li>High deductible health plan </li></ul></ul><ul><ul><li>Most in-network services </li></ul></ul><ul><ul><ul><li>You pay 100% up to deductible </li></ul></ul></ul><ul><ul><ul><li>10% up to coinsurance maximum </li></ul></ul></ul><ul><ul><ul><li>0% for the remaining part of the plan year </li></ul></ul></ul><ul><ul><li>Most out-of-network services </li></ul></ul><ul><ul><ul><li>You pay 100% up to deductible </li></ul></ul></ul><ul><ul><ul><li>50% up to coinsurance maximum </li></ul></ul></ul><ul><ul><ul><li>0% for the remaining part of the plan year </li></ul></ul></ul><ul><li>HealthFund HSA for out-of-pocket costs </li></ul><ul><ul><li>ASU contributions & Elective employee contributions </li></ul></ul><ul><ul><li>If withdrawals are more than HealthFund balances, subject to “overdraft” fees </li></ul></ul><ul><ul><li>If used for non-medical expenses, subject to additional fees </li></ul></ul>
  16. 16. Dental PER PAY PERIOD PREMIUMS Effective – October 1, 2009 Single Employee + 1 Family Pre-Paid Total Dental $2.23 $6.24 $6.46 <ul><ul><li>PPO/Indemnity </li></ul></ul>Delta Dental $13.78 $31.35 $54.52
  17. 17. Vision – Per Pay Period SINGLE EMPLOYEE + 1 FAMILY $2.23 $6.24 $7.78
  18. 18. 2009-2010 Life & Disability Changes <ul><ul><li>Short-term Disability & Life Insurance Vendor: Hartford </li></ul></ul><ul><ul><ul><li>Hartford replaces all products previously offered by The Standard Insurance Company (STD, LTD, Basic and Supplemental Life) </li></ul></ul></ul><ul><ul><ul><li>No changes to university options under UNUM </li></ul></ul></ul><ul><ul><ul><li>Aetna is not included in this open enrollment, all enrollments remain </li></ul></ul></ul><ul><ul><ul><li>ASU Life – New ASU Open Enrollment Options in November </li></ul></ul></ul><ul><ul><li>No plan design change for short-term disability </li></ul></ul><ul><ul><li>No plan design change for ADOA’s supplemental life </li></ul></ul><ul><ul><li>Only design addition is to dependent life – 50,000 option for employees with at least 35,000 in supplemental life </li></ul></ul>
  19. 19. Employee Resources
  20. 20. Employee Resources cont’d
  21. 21. Coming Soon…ASU Open Enrollment <ul><li>November 1 st through 30 th </li></ul><ul><ul><li>Flexible Spending Account </li></ul></ul><ul><ul><ul><li>Health Care FSA </li></ul></ul></ul><ul><ul><ul><li>Dependent Care FSA </li></ul></ul></ul><ul><ul><li>Possibly new life and long-term care options </li></ul></ul><ul><li>Effective January 1, 2010 </li></ul>
  22. 22. How to Enroll? <ul><li>Link from Open Enrollment: </li></ul><ul><ul><li> </li></ul></ul><ul><li>My ASU: </li></ul><ul><ul><li> </li></ul></ul>
  23. 23. Dependent Eligibility and Reporting <ul><li>Federal legislative change </li></ul><ul><ul><li>Mandatory Insurer Reporting Law (Section 111 of Public Law 110-173) Effective Jan 1, 2009 </li></ul></ul><ul><ul><li>Must submit dependent/spouse Social Security numbers to continue dependent coverage </li></ul></ul>
  24. 24. Dependents cont’d <ul><ul><li>Exceptions </li></ul></ul><ul><ul><ul><li>6-8 week grace period for newborns; and </li></ul></ul></ul><ul><ul><ul><li>Dependents with Visas – Must provide copy of Visa </li></ul></ul></ul><ul><ul><li>ASU communication mailed to home week of August 17th </li></ul></ul><ul><ul><li>System requires SSN for any new dependent or edits on existing dependents. </li></ul></ul><ul><li>NOTE: Due to system set-up, beneficiary SSNs are required when entering new or editing an existing beneficiary. Employees may submit a form to enter a beneficiary without an SSN. </li></ul>
  25. 25. Dependents cont’d