2012 Employee Benefits   Presented by:
2012 Benefit Presentation  •Benefit   Overview  •How   Do I Choose the Right Medical Plan?  •Other   Benefits   Vision, De...
2012 Benefit Overview  •   Medical Coverage – Health Plus - ww.healthplus.org        Cofinity PPO Network - www.cofinity.n...
How To Choose the Right Medical Plan?   e    Cost per pay check (Pre-tax)   c    Risk (Potential Out-Of-Pocket Cost), Plan...
How Much Does it Cost?                        Standard           HSA                          2012             2012       ...
Choosing the Right Plan:PPO vs. HMO   PPO Coverage                                                                        ...
Choosing the Right Plan:HDHP w/HSA      2 Options: HMO or PPO      Plans require deductibles be met in full prior to cov...
HDHP (w/HSA)                              Plans require copays for Rx, office visits,                                     ...
HDHP(w/HSA)PPO or HMO:   Prescription Drug Coverage   Prescription   drug coverage is based on the use of a medication   ...
What is a Health Savings Account?     Two components that work     together to meet our                                   ...
Eligible Expenses with HSA  Most out-of-pocket health care expenses:  •Deductibles & Coinsurance  •Medical, Dental and Vis...
HMO or PPO                             Plans require copays for Rx, office visits,                                       E...
Flexible Spending Accounts     Health Care Reimbursement Account - $4,000                                                ...
Vision SummaryNational Vision Administrators                                             In-Network                       ...
Dental – Assurant PPO  HIGH PLAN                       In-Network                  Non-network  Deductible                ...
How Much Does it Cost?                    2012                           2012   Enrollment   NVA Vision Plan   Enrollment ...
Life & Accidental Death &Dismemberment – Mutual of Omaha      Core Life & AD&D benefit provided       by Olga’s at no cos...
DisabilityMutual of Omaha   Short-Term Disability   60% of weekly earnings to a maximum of $500   Payable on the 8th day...
Access Point Convenient Online Enrollment                 ins:            t Beg re       menE nroll te of Hi :        a   ...
Questions?  Please Contact:    Roni Pittiglio    roni.pittiglio@olgaskitchen.com    (248) 362-9398    Lisa Procter    lisa...
Carrier Contact Information       MEDICAL & RX              VISION                                 NVA – National Vision A...
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2012 olga's new hire presentation vo

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  • Employee Life Insurance: This is TERM insurance. Upon separation from the company, an employees insurance ends the day of separation. Dependent Life Insurance: Coverage includes spouse & child. If you have a spouse and no child, the insurance specifically covered only the spouse at the amount listed for the spouse. Basically the child coverage becomes non-existent if you do not have a child. This is a package deal and no separation is made between the spouse and child coverage's.
  • 2012 olga's new hire presentation vo

    1. 1. 2012 Employee Benefits Presented by:
    2. 2. 2012 Benefit Presentation •Benefit Overview •How Do I Choose the Right Medical Plan? •Other Benefits Vision, Dental, Life, AD&D & Disability •Enrollment Timeframes 2
    3. 3. 2012 Benefit Overview • Medical Coverage – Health Plus - ww.healthplus.org Cofinity PPO Network - www.cofinity.net Cofinity is a large Network • Health Savings Accounts - PNC Bank of Providers that Health Plus offers to PPO Plan participants, making it easier to stay In-Network when • Flexible Spending Accounts - TASC obtaining services. • Vision – NVA (National Vision Administrators) • Dental Coverage - Assurant • Life and Disability Coverage - Mutual of Omaha 3
    4. 4. How To Choose the Right Medical Plan? e Cost per pay check (Pre-tax) c Risk (Potential Out-Of-Pocket Cost), Plan Type & Design a. Provider Network & Access to Care  Health Plus (HMO)  Cofinity (PPO) b. Coverage Type & Plan Detail  HMO (in-network ONLY)  PPO (in and out-of-network coverage)  High Deductible Health Plan (w/HSA)  Standard Plan (w/FSA) 3. Health Care Spending Options (Pre-tax)  HSA (Health Savings Account)  FSA (Flexible Spending Account) 4
    5. 5. How Much Does it Cost? Standard HSA 2012 2012 Enrollment Health Plus Health Plus HMO Status Standard HMO HDHP HMO HSA Cost Per Pay Cost Per Pay Single $64.49 $21.26 2 Person $142.59 $45.33 Family $170.94 $54.22 2012 2012 Enrollment Health Plus Health Plus PPO Status Standard PPO HDHP PPO HSA Cost Per Pay Cost Per Pay Single $73.91 $42.05 2 Person $163.78 $92.10 Family $196.36 $110.35 5
    6. 6. Choosing the Right Plan:PPO vs. HMO PPO Coverage Find providers at Inand Out-of-network benefits available www.cofinity.net No primary care physician required Higher per pay check cost than HMO HMO Coverage Find providers at In-network www.healthplus.org benefits ONLY Must choose a primary care physician Referrals Required (12 month option) Less per pay check cost than PPO Large provider network throughout Michigan *Preventive care available in all plan options at no cost to the employee (no max; no copay) *Adult children up to age 26 can be covered regardless of student, marital or earnings status.
    7. 7. Choosing the Right Plan:HDHP w/HSA  2 Options: HMO or PPO  Plans require deductibles be met in full prior to coverage (except for preventive care at 100%)  Coinsurance & Rx co-pay begin AFTER deductible is met  All out-of-pocket expenses accumulate to maximum out-of- pocket  Contracts with two or more MUST meet full Family deductible amount before coverage begins (except for preventive care). 7
    8. 8. HDHP (w/HSA) Plans require copays for Rx, office visits, ER visits, etc., AFTER Deductible thatPPO or HMO DO count to out-of-pocket maximum. HMO (HealthPlus) PPO In-Network In-Network Out-of-Network Cofinity Deductible $2000/$4000 $2,500/$5,000 $10,000/$20,000 Coinsurance 80% 90% 70% Coinsurance $2,000/$4,000 $2,500/$5,000 $10,000/$20,000 Maximum Preventive Health 100% 100% 70% of Reasonable and Services Customary Charges Office Visits $15 Copay $5 Copay 70% After Deductible After Deductible After Deductible Specialist Office $15 Copay 90% 70% Visits After Deductible After Deductible After Deductible Emergency Room $100 Copay 90% 90% After Deductible After Deductible After Deductible Urgent Care $50 Copay 90% 90% Facility Services After Deductible After Deductible After Deductible In-Patient 80% 90% 90% Hospital After Deductible After Deductible After Deductible *See Details in Access Point 8
    9. 9. HDHP(w/HSA)PPO or HMO: Prescription Drug Coverage Prescription drug coverage is based on the use of a medication formulary Copays apply to each prescription you fill (AFTER deductible is met): o $15 for Generic drugs o $60 for Brand Name drugs Contraceptive drugs and implantable contraceptive drugs are included Prescription Mail Order o $30 for Generic drugs/$120 for Brand Name o Filled for up to 90 days 9
    10. 10. What is a Health Savings Account? Two components that work together to meet our HDHP personal healthcare needs. $$ Member Preventive Care 100% Deductible & Coinsurance Responsibility Health Deductible Health Plan (HDHP) HSA  Preventive care covered 100% Health Savings Account (HSA)  Employee allocates to HSA  Employee controls HSA  deposit balance to receive Olga’sYou must May roll$1/monthover at year-end 2012 HSA Limitscontribution of $20, $40, or $60 /month into your Single: $3,100HSA, based on enrollment status. Family: $6,250 Age 55+: $1,000 10
    11. 11. Eligible Expenses with HSA Most out-of-pocket health care expenses: •Deductibles & Coinsurance •Medical, Dental and Vision •Prescription drug costs •Some over-the-counter medications (with prescription) •COBRA and Medicare premiums •Qualified long-term care insurance and expenses *Remember* What is not used, rolls over to the next year! 11
    12. 12. HMO or PPO Plans require copays for Rx, office visits, ER visits, etc., that do NOT count toward maximum out-of-pocket.Standard Plans HMO (HealthPlus) PPO In-Network In-Network Out-of-Network Cofinity Deductible $750/$1,500 $1,500/$3,000 $3,000/$6,000 Coinsurance 80% 80% 60% Coinsurance Maximum $3,000/$6,000 $3,000/$6,000 $6,000/$12,000 Preventive Health 100% 100% 60% of Reasonable and Services Customary Charges Office Visits $20 Copay $20 Copay 60% After Deductible Specialist Office Visits $20 Copay $40 Copay 60% After Deductible Emergency Room $100 Copay $100 Copay 80% After Deductible Urgent Care Facility $35 Copay $50 Copay 60% Services After Deductible In-Patient Hospital 80% 80% 60% After Deductible After Deductible After Deductible Prescription Copay $10/$40 $15/$50 $15/$50 Mail Order 2X, 90 Day Pay & Receive Reim. *See Details in Access Point 12
    13. 13. Flexible Spending Accounts  Health Care Reimbursement Account - $4,000 These are “use it or lose Funded with pre-tax payroll deductions it” accounts, so please be Covers medical, prescription drug, dental and vision. conservative with your elections.  Dependent Care Reimbursement Account - $5,000 Funded with pre-tax payroll deductions You must deposit $1/month to receive Olga’s contribution of $20, $40, or $60 /month into your FSA, based on enrollment status. 13
    14. 14. Vision SummaryNational Vision Administrators In-Network Out-of-Network Exam Covered 100% (Reimbursed Amounts) Once Every 12 Months After $10 Co-pay Up to $52 Lenses Standard Glass or Plastic Single Vision Up to $55 Once Every 12 Months Covered 100% Bi-focal Up to $75 After $25 Copay Tri-focal Up to $95 Lenticular Up to $125 Frame Covered up to $130 Up to $80 Once Every 24 Months Retail Allowance (Additional discount on the balance may apply at some providers) Contact Lenses Elective: Elective: Once Every 12 Months Covered Up to $130 Retail Allowance Up to $130 (Additional discount on the balance may apply at some providers) Medically Necessary: $210 Medically Necessary: Covered at 100% Visit www.e-nva-com To Find an NVA Provider: https://www.e-nva.com/nva/content/tourist/JSFPEntryTouristPage.jsf Sample Group/Sponsor Number: 50981000101 14
    15. 15. Dental – Assurant PPO HIGH PLAN In-Network Non-network Deductible $0 $50/$150 Type I 100% 100% after deductible Not Applied to Annual Max Not Applied to Annual Max Type II 90% 80% after deductible Type III* 60% 50% after deductible Annual Maximum $1000 $700 Reasonable & Customary Fee Schedule 90th percentile LOW MAC PLAN In-Network Non-network Deductible $50/$150 $100/$300 Type I 100% 70% No Deductible Type II 80% after deductible 50% after deductible Type III 60% after deductible 20% after deductible Annual Maximum $700 $500 Reasonable & Customary PPO Fee Schedule 45% less than PPO Fee Schedule 15
    16. 16. How Much Does it Cost? 2012 2012 Enrollment NVA Vision Plan Enrollment Assurant Dental Status Cost Per Pay Status High Plan Cost Per Pay Single $2.75 Single $8.47 2 Person $4.95 2 Person $17.44 Family $7.15 Family $29.71 2012 Enrollment Assurant Dental Status Low Mac Plan Cost Per Pay Single $3.10 2 Person $7.43 Family $15.43 16
    17. 17. Life & Accidental Death &Dismemberment – Mutual of Omaha  Core Life & AD&D benefit provided by Olga’s at no cost to you. ◦ Benefit is 1X annual salary to $50,000  Voluntary Coverage (Life Only) ◦ Up to 5X base annual earnings in increments of $10,000 ◦ All increases in coverage require evidence of insurability  Voluntary Dependent Life Available 17
    18. 18. DisabilityMutual of Omaha Short-Term Disability 60% of weekly earnings to a maximum of $500 Payable on the 8th day for up to12 weeks Company Paid Long-Term Disability 60% of monthly earnings to a maximum of $5,000 Payable on the 90th day Company Paid 18
    19. 19. Access Point Convenient Online Enrollment ins: t Beg re menE nroll te of Hi : a ds O n D ent E n s llm k Enro n 2 Wee i With Benefits become active the first of the month following 30 days of full time employment. An HR Representative will contact you with enrollment details. 19
    20. 20. Questions? Please Contact: Roni Pittiglio roni.pittiglio@olgaskitchen.com (248) 362-9398 Lisa Procter lisa.procter@olgaskitchen.com (248) 362-9377 Thank You! 20
    21. 21. Carrier Contact Information MEDICAL & RX VISION NVA – National Vision Administrators Health Plus 800-672-7723 (800) 332-9161 service@e-nva.comwww.e-nva.com www.healthplus.org Claims Adress: www.cofinity.net P.O. Box 2187 Clifton, NJ 07015 Claims Address: P.O. Box 1700 LIFE & DISABILITY Flint, MI 48501-1700 Mutual of Omaha (800) 775-1000 Mail Order Drugs www.mutualofomaha.com Express Scripts Claims Address: (877) 322-8471 Mutual of Omaha Insurance Company www.express-scripts.com Mutual of Omaha Plaza Omaha, NE 68175 DENTAL Assurant Employee Benefits (800) 733-7879 www.assurantemployeebenefits.com HEALTH SAVINGS ACCOUNTS Claims.dental@assurant.com PNC Bank Claims Address: (866) 622-3946 PO BOX 2940 www.pnc.com Clinton, IA 52733 Claims Address: FLEXIBLE SPENDING ACCOUNTS PO BOX 1234 TASC Pittsburgh, PA 52733 (800) 422-4661 www.tasconline.com Claims Address: FSA Reimbursement PO BOX 7308 Madison, WI 53707-7308
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