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Open Enrollment 2011
 

Open Enrollment 2011

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  • Coconino County has been a member of the Northern Arizona Public Employees Benefit Trust (hereinafter NAPEBT) since July 1993 . Other Trust members include the City of Flagstaff, Coconino Community College, Flagstaff Unified School District, Accommodation School, NAIPTA, and Flagstaff Housing Authority. The Trust was formed for the purpose of price stability and cost containment in the purchase of benefits for employees. 1993 County membership in the Trust 2003 we switched to Blue Cross Blue Shield 2006 the Trust became Self Funded NAPEBT directly assumes major costs of claims and expenses – Determines premiums – Determines changes to plan – This can help better align cost of claims/expenses with contributions.
  • Around the time the Trust went self funded you can see the premium costs have decreased to below the National Trend FY06
  • Blue Cross Blue Shield provides the claims administration – They do not set the premiums. The premiums are based on group experience and utilization Went out to bid and now the Pharmacy benefit is carved and will be administered by CVS/Caremark – we will provide more detail in later slides
  • Review the existing plan design – no change to deductibles/PCP copays Highlight the new items Hospital Admit Fee Retail 90 day supply at 2 ½ copay Primary Care versus Specialist Care Why …Total cost of Primary care is less than the cost of a Specialist Advantages …Cost savings to you and NAPEBT Urgent Care versus Emergency Room Going to a personal care doctor or urgent care prior to the emergency room (your condition permitting) for things like the flu, sprains, and sore throats In-Network versus Out-of-Network Why ...The plan has lower negotiated rates with providers Cost difference much higher out-of-network Advantages …You pay less out-of-pocket staying in-network Saves the plan money and makes coverage more affordable for everyone
  • Generic Drugs versus Brand-name Drugs Why …For total cost savings The cost for equivocally the same drug is on average $130 more for brand-name Generics are medically equivalent to their brand-name counterpart Use generic rather than brand-name drugs whenever available Advantages …You and NAPEBT save money Extranet available on 6/1/11 for employees to review Caremark information on line Dedicated NAPEBT phone line will be available on 6/13/11 877-456-0109 Fast Start program available 7/1/11 Employees will just need to call customer care number and ask for the Fast Start program the representative will assist and ask some questions. CVS/Caremark will reach out the physician and request a mail order RX be called in
  • Push toward Wellness initiatives
  • The Trust is a self-funded plan utilizing BC/BS of AZ to administer claims. We are responsible for payment of claims from premium collected from employers. Our strategic initiative for the future focuses on wellness. A healthy workforce is critical to controlling costs related to benefits. We are responsible for our own costs
  • Beginning in FY13, we will offer employees the opportunity to waive the $20 employee cost share by participating in wellness programs. BC/BS of AZ’s “My Blueprint” Health Assessment and Biometrics Screenings will be two of the activities employees will be required to participate in to be eligible for the $20 waiver. The NAPEBT Wellness Committee is working on the details and will scheduling and promoting these activities. Your voluntary participation in biometric testing, BCBS health assessment and other programs identified by the Trust will eliminate the $20 employee cost share for FY 13
  • New premiums will be reflected on the 1 st paycheck in July – Thursday, July 14
  • Benefit eligible employees (30 hours per week-regular status) are automatically enrolled in the Basic Term Life and AD & D Accelerated Death Benefit –May be available if you have a terminal illness. Please visit with Human Resources for additional information.
  • Employees who choose to elect additional supplemental term life insurance coverage will see an increase to monthly cost based on their age and amount of elected coverage.
  • 2011 Annual Maximum: $3050 Single $6150 Family + additional $1,000 if age 50 or older.
  • You can find more information on NAPEBT.com Summary of group benefits Cost sheets General notices Or visit cocoweb IF YOU DO NOT WISH TO MAKE CHANGES, NO ACTION IS REQUIRED . IF YOU WISH TO CONTINUE OR ENROLL IN THE FLEXIBLE SPENDING ACCOUNT, YOU MUST COMPLETE ENROLLMENT FORMS.

Open Enrollment 2011 Open Enrollment 2011 Presentation Transcript

  • Open Enrollment NORTHERN ARIZONA PUBLIC EMPLOYEES BENEFIT TRUST Plan Year July 1, 2011 – June 30, 2012 May 2 – 31 2011
  • OPEN ENROLLMENT OBJECTIVES
    • NAPEBT Trends and History
    • Medical Plans
    • Dental Plans
    • Vision Plans
    • Life Insurance Plans
    • Flexible Spending Accounts
    • Health Savings Account
    • Considering Retirement?
  • NAPEBT Medical Plans Trends & History
  • NAPEBT Northern Arizona Public Employees Benefit Trust
    • Coconino County
    • City of Flagstaff
    • Coconino Community College
    • Flagstaff Unified School District
    • NAIPTA
    • Northern Arizona Intergovernmental Public Transit Authority
    • Housing Authority
    • Accommodation Schools
  • NAPEBT – Trends National health premium trend data is from the Hay Benefits Reports (Hay Group) adjusted from a calendar year basis to correspond with NAPEBT's fiscal year. The 2010 trend data was not available from Hay, therefore, the 2009 trend increase percentage was used. For the 2006-2007 plan year the NAPEBT contribution rates are a blend of the one plan offered (7/1/06-12/31/06) and three plans offered (1/1/07-6/30/07) weighted by enrollment. For the 2008-2009 and 2009-2010 plan years the NAPEBT rates are a blend of all three plans weighted by enrollment.
  • NAPEBT – Total Medical Claims Paid $525.59 $ 482.60 3,615 3,442 $22,797,920 $ 9,967,061 FY10 7/10-12/10 $476.41 3,687 $21,078,317 FY09 $450.30 3,609 $19,499,142 FY08 Claims per Employee per Month Average # of Employees Total Claims Fiscal Year
  • NAPEBT – Large Medical Claims Paid
  • NAPEBT Medical Plans Blue Cross Blue Shield of Arizona Group # 19676 NAPEBT Rx Plans CVS/Caremark #3172 Plan Year July 1, 2011 – June 30, 2012
  • MEDICAL PLAN EFFECTIVE July 1, 2011 After ded – 20%/$5 min $5/$35/$55/$105 $5/$35/$55/$105 Rx Retail Copay 20% after ded $100* $100* Inpatient Hospital Admit Fee In-Network Buy-Up Plan Base Plan HDHP Calendar Year Deductible: Per person Per family $500 $1,000 $750 $1,500 $1,250** $2,500** PCP Copay – Per visit $25 $35 80%/20% Specialist Copay – Per visit $35 $45 80%/20% Chiropractic Copay $35 $45 80%/20% Urgent Care Copay $50 $75 80%/20% Emergency Room Access Fee $100* $150* $100* Member Coinsurance 20% after ded 20% after ded 20% after ded Out of Pocket Maximum: Per person Per family $3,000 $6,000 $3,000 $6,000 $4,000 $8,000 Rx Retail 90 day Copay 2.5x Copay 2.5x Copay After ded – 20%/$5 min Rx Mail Order 90 day Copay 2x Copay 2x Copay After ded – 20%/$5 min Out-of-Network Calendar Year Deductible: Per person Per family $1,000 $2,000 $1,500 $3,000 $1,250** $2,500** Member Coinsurance 40% after ded 40% after ded 40% after ded *Access/Admit Payment and Deductible applied prior to 80%/20% coinsurance **The In and Out-of-Network deductibles are combined for HDHP.
    • Two ID cards
      • Medical and Rx
      • Continue to use same pharmacies
    • Mail Order
      • Will need a new prescription
      • Fast Start program
    • 90 days at Retail for 2-1/2 times copay
    • Grandfathering of drugs – first 6 months
      • A small percentage of drugs will change tiers after 6 months (January 1, 2012)
      • Will receive a letter if your drug is changing
    • Register at Caremark.com
      • Check drug costs
      • Compare prices of Generic vs. Retail
    CVS/Caremark New Rx Vendor MEDICAL PLAN EFFECTIVE July 1, 2011 Dedicated NAPEBT phone line available on 6/13/11 877-456-0109
  • MEDICAL PLAN EFFECTIVE July 1, 2011 Employee Cost Sharing Approved & Adopted by NAPEBT The Board of Supervisors has approved the payment of the $20 cost share on behalf of County employees for FY 12 only
    • Historically, NAPEBT Employers funded 100% of employee base level premium
    • NAPEBT Employers cannot continue to shoulder full cost
    • $20 per month cost share applied to all medical plans offered by the Trust
    • $240 savings for employees enrolled in medical plan
    • County contribution - $20 per employee per month (1,042) =$229,240
    • Trust Reserves – One month at $20 per employee (1,042) employees = $20,840
  • Wellness Incentive Program July 2012 – June 2013
    • NAPEBT – Self-funded Plan
    • Rates driven by claims experience
    • Increase of large claims
    • Increased frequency of in-patient hospitalization
    • Improved Health of Employees
    • Long-term results
    • Return on Investment
    • Studies show a $4 return for every dollar spent on Wellness programs.
    • Lower costs for everyone
  • Wellness Incentive Program July 2012 – June 2013
    • Opportunity to Waive $20
    • Employee participates in Wellness Program
      • Complete Biometric Testing
        • Fall 2011 Health Fair
        • Wellness participation Jan – May 2012
      • Complete MyBluePrint Health Assessment
        • www.azblue.com
    More information coming soon!
    • $20 Employee Cost Share
        • $20 per month added to employee cost for Base and Buy-Up plans
        • $20 decrease to HSA / FSA contribution on HDHP.
  • MEDICAL PLAN EFFECTIVE July 1, 2011 Dependent Employee HDHP/HSA - $1,250 Deductible * $47.68 per month/$572.15 per year employer contribution to HSA or FSA Dependent Employee Base Plan - $750 Deductible Total for Family Dependent Employee Buy-Up Plan - $500 Deductible Medical Plan FY12 $ 657.30 $ 425.10 $ 731.04 $ 472.78 $1,310.28 $ 795.70 $ 514.58 Monthly Premium $ 402.07 $ 452.78* $ 402.07 $ 452.78 $ 854.85 $ 402.07 $ 452.78 County Contribution $ 0.00 $ 20.00* $ 0.00 $ 20.00 $ 20.00 $ 0.00 $ 20.00 FY12 Employee Cost Share County Contribution $255.23 $ 0.00 $ 328.97 $ 0.00 $ 435.43 $ 393.63 $ 41.80 Employee Cost per Month $ 9.56 $ 127.62 $ 0.00 $ 0.00 $ 12.31 $ 164.48 $ 0.00 $ 0.00 $ 16.31 $ 217.72 $ 14.74 $ 196.82 $ 1.57 $ 20.90 Difference Employee Cost Per Paycheck Effective July 1, 2011 Employee Cost Per Paycheck
  • Employee Premium Holiday The Month of December at Last Year’s Rates! Total Cost to NAPEBT for Employee Premium Increase Holiday: $ 75,100 MEDICAL PLAN EFFECTIVE July 1, 2011 $ 0.00 $ 9.56 $ 0.00 $ 12.31 $ 1.57 $ 14.74 $ 16.31 Savings Per Paycheck $ 0.00 $ 19.12 $ 0.00 $ 24.62 $ 3.14 $ 29.48 $ 32.62 Savings For Month HDHP Employee Dependent Base Plan Employee Dependent Buy-Up Plan Employee Dependent Total for Family Medical Plan FY12
    • Mayo Clinic in Arizona
      • Is an in-network Provider on all plans
      • Includes Mayo Clinic and Mayo Clinic Hospital Services
      • Identify as member of NAPEBT
    • Waivers of Medical Coverage
      • other coverage under a qualified group employer’s plan that is not through another NAPEBT employer, under Medicare or a qualified public health plan such as AHCCCS
      • Must provide enrollment confirmation
    FYI… Useful Information MEDICAL PLAN EFFECTIVE July 1, 2011
    • Deductibles run on calendar year
      • January 1st – December 31st
    • Dual-spouse Deductible Coordination
      • Husband and wife employed by a NAPEBT employer.
      • Base and buy-up plans only.
      • One spouse must have family coverage.
      • Indicate on the Blue Cross enrollment form that your spouse works for NAPEBT and provide the spouse’s ID number.
    FYI… Useful Information MEDICAL PLAN EFFECTIVE July 1, 2011
    • Member ID Cards
      • Have available at every appointment!
  • Patient Protection and Affordable Care Act Healthcare Reform
    • Pre-existing Condition Restrictions
      • Removed for children younger than age 19
      • Still applies for adults until 2014
    • Preventive Services
      • No office visit co-pay for recommended screenings, general physicals and vaccinations
    • Lifetime Benefit Maximum
      • Lifetime benefit limits removed
    • Eligible Dependents to Age 26
      • Without regard to
        • Student Status
        • Marital Status
        • Financial Dependence
      • Only applies to legal child of employee
      • Does not extend to the spouse or child(ren) of the adult child
      • Applies ONLY to Medical plan and Flexible Spending Accounts
    MEDICAL PLAN EFFECTIVE July 1, 2011
  • NAPEBT Dental Plans Delta Dental of Arizona Group # 1331 Plan Year July 1, 2011 – June 30, 2012
  • DENTAL PLAN EFFECTIVE JULY 1, 2011 50% $1,000 Maximum Lifetime Benefit Orthodontia (Age 8 – 19) $50 per person $150 per family Calendar Year Deductible 100% Routine Services 80% Basic Services 50% Major Services $2,000 Annual Maximum Benefit per Person Buy- Up Plan Dental Plan FY12 $50 per person $150 per family 50% $1,000 Maximum Lifetime Benefit 50% 80% 100% $1,000 Base Plan
  • DENTAL PLAN EFFECTIVE JULY 1, 2011 Total for Family Dependent Employee Base Plan - $1,000 Annual Benefit Total for Family Dependent Employee Buy-Up Plan - $2,000 Annual Benefit Dental Plan FY12 $ 71.20 $ 40.12 $ 31.08 $ 111.24 $ 62.66 $ 48.58 Monthly Premium $ 31.08 $ 0.00 $ 31.08 $ 31.08 $ 0.00 $ 31.08 County Contribution $ 40.12 $ 40.12 $ 0.00 $ 80.16 $ 62.66 $ 17.50 Employee Cost per Month $ 0.97 $ 20.06 $ 0.97 $ 20.06 $ 0.00 $ 0.00 $ 1.56 $ 40.08 $ 1.31 $ 31.33 $ 0.25 $ 8.75 Difference Employee Cost Per Paycheck Effective July 1, 2011 Employee Cost Per Paycheck
  • NAPEBT Vision Plans VSP Group # 12239817 Plan Year July 1, 2011 – June 30, 2012
  • VISION PLAN EFFECTIVE JULY 1, 2011 $25 Material Co-pay Lenses and/or Frames $120 Allowance 20% off additional cost 15% discount off contact lens exam $120 allowance for exam & contacts $25 Material Co-pay Lenses and/or Frames $15.00 Co-pay Buy-Up Plan 15% Discount on Contact Lens Exam 20% Discount on a complete pair of glasses. $15.00 Co-pay Core Plan Employee Only In-Network Frames Once every 24 months Contacts Instead of Glasses Prescription Lenses Once every 12 months Eye Exam Once every 12 months Vision Plan FY12
  • VISION PLAN EFFECTIVE JULY 1, 2011 So what’s the bottom line? There is no change to employee payroll deductions for vision coverage for 2011-2012. $ 7.10 $ 14.20 $ 0.77 $ 14.97 $ 4.00 $ 8.00 $ 0.00 $ 8.00 $ 3.10 $ 6.20 $ 0.77 $ 6.97 Buy-Up Plan Employee Dependent Total for Family Core Plan -Employee ONLY $ 0.00 $ 0.00 $ 0.77 $ 0.77 Employee Employee Cost per Paycheck Employee Cost per Month County Cost Monthly Premium Vision Plan FY12
  • NAPEBT Life Insurance Plans Minnesota Life Policy # 33585 Plan Year July 1, 2011 – June 30, 2012
  • LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
    • Basic Term Life & Accidental Death & Dismemberment Insurance
    • $40,000 coverage
      • Provided by Coconino County at no cost to the employee ($7.40 x 1,042 = $92,530/annual cost to County)
      • May convert to an individual policy upon separation of employment
      • Remember to keep Beneficiary information up to date
    • Voluntary Term Life Insurance
      • Employee may increase elected coverage amount by $10,000 at Open Enrollment without underwriting (up to the Guaranteed Issue limit of $100,000)
      • Insure spouse up to half of employee’s voluntary coverage election
      • Insure children @ $10,000
    LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
  • LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
    • Voluntary Term Life Insurance
      • Rate Change
      • % of Increase Varied by Age Bracket
      • Child Rate – No Change
    $ 4.75 $ 3.25 Spouse – Age 47 $25,000 Coverage $ 21.20 $ 14.40 Spouse – Age 59 $40,000 Coverage $ 23.00 $ 19.00 Employee – Age 52 $100,000 Coverage $ 7.20 $ 5.60 Employee – Age 36 $80,000 Coverage Effective July 1, 2011 Previous Monthly Rate
  • Flexible Spending Accounts ASI Flex Plan Year July 1, 2011 – June 30, 2012
      • Flexible Spending Accounts
        • Reduce Tax Liability
        • Health Care FSA (HCFSA) – allows you to set aside pre-tax dollars to pay for eligible health care expenses not covered by insurance or reimbursed from any other source.
          • Limited Purpose Health Care FSA (use with a High Deductible Health Plan (HDHP) and Health Savings Account (HSA)
          • (dental, vision and preventive care expenses only)
          • General Purpose Health Care FSA (qualified health care expenses)
        • Dependent Care FSA (DCFSA) – allows you to set aside pre-tax dollars to pay for eligible day care expenses for children up to the age of 13, disabled children over age 13, and elder care.
    FSA PLAN EFFECTIVE JULY 1, 2011
    • FSA – Medical
      • Unreimbursed Medical, Prescription, Dental, & Vision expenses
      • Up to $3,000 Per Year
      • Debit Card
      • Reimbursement by Check or Direct Deposit
      • Full Amount Elected Available Immediately
      • MUST RE-ENROLL EACH YEAR!
      • Use or Lose – Be Conservative!
    FSA PLAN EFFECTIVE JULY 1, 2011
    • Ineligible Health Care Expenses
      • Cosmetic Expenses
        • Rogaine, bleaching of teeth, cosmetic surgery (other than reconstructive surgery following a mastectomy for cancer)
      • Dietary Supplements such as Vitamins
      • Personal Use Items
      • Health Club Memberships
      • Tanning Salon
      • Over-the-Counter Medications Unless Prescribed by a Doctor
    FSA PLAN EFFECTIVE JULY 1, 2011
    • FSA – Dependent Care
      • Up to $5,000 per year
      • Reimbursement by Check or Direct Deposit
      • Funds Available as Contributed
      • MUST RE-ENROLL EACH YEAR!
      • Use or Lose – Be Conservative!
    FSA PLAN EFFECTIVE JULY 1, 2011
    • Ineligible Dependent Care Expenses
      • School Expenses for Children in Kindergarten or Older
      • Overnight Camping
      • Expenses for a Child Age 13 or older (unless disabled)
      • Expenses for Nighttime Babysitting
      • Daycare Expenses During an Extended Leave of Absence
      • When a Dependent is Providing Child Care
      • Expenses Paid to Your Child Under the Age of 19
      • (even if child is not your dependent)
    FSA PLAN EFFECTIVE JULY 1, 2011
  • Health Savings Accounts HealthEquity Plan Year July 1, 2011 – June 30, 2012
    • $47.68 per month ($572.16 per year)
    • Health Savings Account if Eligible
      • Who is NOT eligible for an HSA?
      • Individuals entitled to Medicare (eligible & enrolled)
      • Individuals covered under another non-HDHP
      • Individuals enrolled in AHCCCS or Medicaid or have used IHS
    • If NOT Eligible for HSA you will be enrolled in Flexible Spending Account (Health)
    HDHP Employer Contribution HSA PLAN EFFECTIVE July 1, 2011
  • HSA PLAN EFFECTIVE JULY 1, 2011
      • Health Savings Accounts
        • Only available with election of HDHP
        • Reduce Tax Liability
        • Use like flexible spending account for Medical, Prescription, Dental and Vision
        • Unspent money rolls over year after year; NOT use it or lose it
        • Take it with you when you leave or retire
          • Pay for COBRA, Medicare or Long Term Care Premiums
          • Never pay taxes as long as used for qualified expenses
    • HealthEquity and Blue Cross Blue Shield of Arizona have created an integrated Health Savings Account (HSA) solution.
    • Your claims information will now be available with your HSA account information for easier management of claims payment and review.
    • When you login to the Blue Cross web site (www.blueaz.com) you can click on a link to take you to the HealthEquity portal where you can view your claims, see how much you owe, and process payment (pay a provider, or yourself) – all from the same website.
    FYI… Useful Information HSA PLAN EFFECTIVE JULY 1, 2011
  • Considering Retirement? Coconino County Retiree Benefits
  • Considering Retirement?
    • 10 Years of Continuous Service with Coconino County
    • Retiring with a Pension through an AZ State Retirement System
    • Medical, Dental and Vision Benefits end at age 65
    • Life Insurance Reduces to ½ Face Value at Age 65; End at Age 70
    • Contact Human Resources with retirement questions
    RETIREMENT EFFECTIVE JULY 1, 2011
  • Questions? OPEN ENROLLMENT 2011 ? ? ?