BenefitsOE_0910.ppt
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    BenefitsOE_0910.ppt BenefitsOE_0910.ppt Presentation Transcript

    • 2009-2010 STATE OPEN ENROLLMENT
    • Agenda
      • Mandatory Open Enrollment
      • Dependent Eligibility and Reporting Changes
      • Cost-sharing Changes
      • Coverage Changes
      • Employee Benefits Communications
        • Guide
        • Benefits Open Enrollment website
        • Expo and Information Meetings
        • Contact Information
    • 2009–2010 ADOA Open Enrollment
      • Thursday, Aug. 20 – Friday, Sept. 4 at 5 PM
      • All employees must re-enroll – If not, will be randomly defaulted into medical EPO
      • Changes effective Oct 1 st
      • Rates effective with Oct 9 th paycheck
      • Plans: medical, dental, vision, short-term disability, supplemental life and dependent life (not Aetna).
    • 2009-2010 Open Enrollment
      • Highlights of 2009-2010 Open Enrollment
        • Cost-sharing
        • New Coverage Tier
        • Elimination/reduction of some benefits
        • New Plan Design
        • New Vendors
        • We’re learning with you!
    • Cost Sharing Changes
      • Monthly Medical and Dental Rates Increase
        • New Medical 4-tier Rate Structure - ( for single; emp + 1 child; emp + 1 adult; family ) to align premiums with costs
        • Moderate to significant rate increases for EPO and PPO participants
        • New Vision 3-tier Rate Structure as Dental
        • Same employer contribution for both Dental Plans
      • Higher Out-of- Pocket Costs
        • Higher co-payments in EPO
        • Higher coinsurance and deductibles in PPO
        • New HSA Option with HealthFund HSA for out-of-pocket costs
    • 2009-2010 Health Plan Changes
      • New Pharmacy Benefits Vendor: MedImpact
      • New EPO/PPO Medical Networks: Aetna, AmeriBen, CIGNA & UHC
        • Statewide & National Coverage – eligibility no longer based on Home Address
        • Transition of Care – Details available on website
        • International – EPO/HSA (Emergency & Urgent Care Only; PPO (Emergency & Urgent Care at In-Network Benefit Level)
    • 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
    • Coverage Changes
      • Prescription Drugs
        • “ Dispense as Written” Brand Name (if generic available) must pay copayment plus difference in cost between brand and generic
        • Limited to meds that do not have equally effective over-the-counter substitute
        • Existing active prescriptions will continue
      • Home Health limited to 168 hours per plan year
      • Bariatric Surgery covered if 35+ body mass index plus two or more medical conditions:
        • Type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers
    • Coverage Changes
      • Co-pays/Deductibles
      • EPO – No Deductible
      • PCP $15
      • Specialist $30
      • Preventative $15
      • OB/GYN $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
    • Coverage Changes
      • EPO
      • Outpatient Services $50
      • Emergency
        • Ambulance $ 0
        • ER $125
        • Urgent Care $40
        • Hospital Admission $150
        • Maternity Admission $250
        • Per baby
    • Coverage Changes
      • PPO – In-Network
      • Outpatient Services $50
      • Emergency
        • Ambulance $ 0
        • ER $125
        • Urgent Care $40
        • Hospital Admission $150
        • Maternity Admission $250
        • Per baby
      • PPO – Out-of-Network
      • Outpatient Services 50%
      • Emergency
        • Ambulance – Amount above In-Network Rate
        • ER $125
        • Urgent Care 50%
        • Hospital Admission 50%
        • Maternity Admission 50%
    • Coverage Changes
      • Services no longer covered:
        • Cosmetic Surgery Complications
        • Erectile Implants
        • Infertility Services
        • Surrogacy
        • TMJ Surgery
    • Health Plan Changes cont’d
      • Avesis renewed, but will also provide a discount card to employees who waive vision insurance
      • Dental contract was not subject to renewal
      • Introduction of Health Savings Account Option
    • What is an HSA?
      • Health Savings Account (HSA) Option
        • High deductible health plan
        • Most in-network services
          • You pay 100% up to deductible
          • 10% up to coinsurance maximum
          • 0% for the remaining part of the plan year
        • Most out-of-network services
          • You pay 100% up to deductible
          • 50% up to coinsurance maximum
          • 0% for the remaining part of the plan year
      • HealthFund HSA for out-of-pocket costs
        • ASU contributions & Elective employee contributions
        • If withdrawals are more than HealthFund balances, subject to “overdraft” fees
        • If used for non-medical expenses, subject to additional fees
    • Dental PER PAY PERIOD PREMIUMS Effective – October 1, 2009 Single Employee + 1 Family Pre-Paid Total Dental $2.23 $6.24 $6.46
        • PPO/Indemnity
      Delta Dental $13.78 $31.35 $54.52
    • Vision – Per Pay Period SINGLE EMPLOYEE + 1 FAMILY $2.23 $6.24 $7.78
    • 2009-2010 Life & Disability Changes
        • Short-term Disability & Life Insurance Vendor: Hartford
          • Hartford replaces all products previously offered by The Standard Insurance Company (STD, LTD, Basic and Supplemental Life)
          • No changes to university options under UNUM
          • Aetna is not included in this open enrollment, all enrollments remain
          • ASU Life – New ASU Open Enrollment Options in November
        • No plan design change for short-term disability
        • No plan design change for ADOA’s supplemental life
        • Only design addition is to dependent life – 50,000 option for employees with at least 35,000 in supplemental life
    • Employee Resources
    • Employee Resources cont’d
    • Coming Soon…ASU Open Enrollment
      • November 1 st through 30 th
        • Flexible Spending Account
          • Health Care FSA
          • Dependent Care FSA
        • Possibly new life and long-term care options
      • Effective January 1, 2010
    • How to Enroll?
      • Link from Open Enrollment:
        • www.asu.edu/hr/benefits/2009OE_generalinfo.html
      • My ASU:
        • my.asu.edu
    • Dependent Eligibility and Reporting
      • Federal legislative change
        • Mandatory Insurer Reporting Law (Section 111 of Public Law 110-173) Effective Jan 1, 2009
        • Must submit dependent/spouse Social Security numbers to continue dependent coverage
    • Dependents cont’d
        • Exceptions
          • 6-8 week grace period for newborns; and
          • Dependents with Visas – Must provide copy of Visa
        • ASU communication mailed to home week of August 17th
        • System requires SSN for any new dependent or edits on existing dependents.
      • 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.
    • Dependents cont’d
    • MAY WE ANSWER YOUR QUESTIONS?