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2012 RMC Benefit Presentation



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  • 1. 2012 BenefitsRiverside Healthcare Choices and Advantages for Riverside Employees
  • 2. 2012 Open EnrollmentBenefit Enrollment Timeline November 7-23: Open Enrollment Nov 8 – Benefit and Wellness Fair Riverside Lobby from 11:00 am to 5:00 pm Nov 14 – Benefit and Wellness Mini Fair to coincide with the Midnight Meal 10pm to Midn. Nov 7-17: Benefit meetings and Q&A sessions Nov 23: Enrollment period ends Dec 2: Confirmation of benefit elections will be mailed to employees’ homes
  • 3. 2012 Open EnrollmentEmployees should confirm their benefit elections andmake any necessary changes.It’s important to confirm your enrollment if you… would like to make changes to your existing elections have NEW dependents to add to your plan(s) (you will need to submit proof of eligible status) Opt Out of health insurance (you must supply proof of insurance each year) want to continue your Flexible Spending Account (the IRS prohibits the automatic rollover of FSA elections from year to year) want to avoid the spousal surcharge (if your spouse is not eligible for benefits with their employer, you must complete the exemption form) want to avoid the tobacco surcharge (if you are enrolled in health insurance, you must indicate your tobacco status for yourself and each dependent enrolled in your plan)
  • 4. Enrollment ProcessLog on to the BenefitsTalk™ website atwww.benefitstalk.com/riversideReview online plan informationReview your current electionsProcess your enrollment for 2012Benefit Call Center representatives areavailable toll free at (866) 932-6851 Monday through Friday from 7AM-11PM and from 7AM-NOON on Saturday.
  • 5. Benefits are part of Total CompensationRiverside’s goal is to provide employees with acompetitive and affordable health insuranceprogram.Riverside receives a discount in plan expenses byparticipating with MCHCRiverside pays 80% of the total cost of healthcarecoverage for employeesAfter enrollment, employees will receive aconfirmation statement that details employee’s totalcompensation including Riverside’s contributions tobenefits costs.
  • 6. Riverside’s costs anticipated to increaseTo continue managing costs in 2012 whileproviding competitive benefits, premiumadjustments have occurred for healthinsurance. Rates can be viewed online during enrollment at www.benefitstalk.com or by calling the Benefit Call Center.There is no increase in dental, vision, lifeinsurance, or long term disability rates
  • 7. Medical Insurance Premium Discounts Earn Medical Insurance Premium Discounts by participating in the REACH Employee Wellness Program If you are enrolled in Riversides group medical insurance, you can earn a $20 premium discount each pay period. To earn the discount you must… meet with your Wellness Coach complete your annual wellness screening get your annual flu shot and for women over 40, get your annual mammography
  • 8. Medical Insurance Premium Discounts If you Opt Out of medical insurance, you must participate in the REACH program to receive your full opt out credit. Full Time Employees who Opt Out must participate in the REACH wellness program to receive the full $45 opt out credit. If you do not participate, you will receive a partial opt out credit of $25. Part Time Employees who Opt Out must participate in the REACH wellness program to receive the full $20 opt out credit. If you choose not to participate you will not receive an opt out credit.
  • 9. REACH Employee Wellness ProgramREACH is a FREE comprehensive wellness program offered toALL Riverside employees. This unique and special benefitprovides person to person coaching and mentoring, usually overthe course of several months, to improve and/or make progress inyour lifestyle habits. For most participants, this results in ahealthier, happier you!The mission of the REACH program is to provide opportunities forall employees to create and maintain healthy and active lifestyles.By improving employees physical and mental wellbeing, theemployee wellness program reflects Riversides mission: "Life is aremarkable journey. Health impacts every step..."For complete details, go to the REACH website atwww.riversidemc.net/reach
  • 10. 100% Coverage for Well-Care Services Beginning January 1, 2012, all Well-Care Services will be covered at 100% at the home hospital and BCBS PPO levels. This change reflects Riverside’s commitment to create a culture that places the health of its employees among the highest priorities. Well-Care Services include immunizations, routine physical exams, routine labs, mammos, etc… anything your doctor orders that is preventative or wellness related. Keep in mind that once a well-care service becomes a diagnostic code, the coverage level changes to the Diagnostic Test level, which is subject to deductible and covered at 90% at the home hospital level or 70% at the PPO level.
  • 11. Plan Design Changes FASTCARE Co-Pay only $10 Available immediately (you don’t have to wait for January 1, 2012 to take advantage of this new benefit Premium Medical Plan no longer available If you are currently enrolled in the Premium Plan, you must elect another plan. If you fail to elect another plan, you will be defaulted into the Preferred Plus Plan. Dental HMO Plan no longer available If you are currently enrolled in the DHMO Plan, you must elect another plan. If you fail to elect another plan, you will be defaulted into Dental PPO Plan B. $5 increase in office visit co-pay: Primary $30 / Speciality $40 Prescription Plan Changes: 90-day supply for 1 co-pay Basic Plan 90-day supply for 2 co-pays for Preferred Plus and Preferred Plans Exclude non-sedating antihistamines because they are OTC There are no plan design changes for vision, life or dependent life insurance, or long term disability.
  • 12. FASTCARE Riverside Employees only pay a $10 Co-Pay starting NOW!! Riversides FastCare clinic offers convenient, economical health care for minor conditions and symptoms such as sore throats, fevers, flu and colds, ear, sinus and urinary tract infections, pink eye, skin rashes and allergies as well as other non-emergency illnesses. FastCare is healthcare from Riverside Medical Center professionals… quality care provided by a nurse practitioner Minimal waiting periods—walk-ins only—no appointments necessary Open 364 days a year, with day and evening hours Location Inside Walmart 2080 N. State Route 50 Bourbonnais, IL 60914 (815) 936-6012 Hours Mon-Fri: 9:00 a.m.-8:30 p.m. ~ Saturday: 9:00 a.m.-5:00 p.m. ~Sunday: 10:00 a.m.-5:00 p.m. ~Holidays: 10:00 a.m.-2:00 p.m. (Closed Christmas Day) Patients must be 18 months or older. Age restrictions exist for select services. For Details, go to www.riversidemc.net/fastcare
  • 13. Fast Care Services Treatments Lab Services• Allergies • Minor sunburn • Monospot (6 yrs & older) • Mononucleosis • Pregnancy test• Athletes foot • Pharyngitis • Rapid strep• Bladder infections • Poison ivy • TB skin test (females 12 yrs & (3 yrs & older) older) • Urinalysis • Ringworm More Services• Ca.m.p physicals • Sinus infections • Free blood pressure• Cold & flu symptoms (5 yrs & older) checks• Cold sores • Sore throat • Immunizations• Ear infections • Sports physicals• Earwax removal • Styes• Impetigo • Swimmers ear• Insect Bites • Upper respiratory• Laryngitis infections• Minor burns and rashes
  • 14. Tips on Choosing BenefitsYour elections should take into considerationyour cost, your needs, the features of eachplan, and your tolerance for risk We suggest comparing the plans based on: MD office visit co-pay and Prescription co-pay Deductible and Maximum out of pocket Bi-weekly premiumsSee details for each plan in the Benefit Bookletavailable at www.benefitstalk.com/riverside,on RiverNet, or in OLIE.
  • 15. Decision WorksheetTo help in the decision process, we havedeveloped a spreadsheet where you mayenter information specific to you and thencompare the costs of each health planoffered. This spreadsheet is availableonline at www.benefitstalk.com/riverside,on RiverNet, and OLIE Note: This worksheet is intended to be used only as a guide in the decision process.
  • 16. Spousal Surcharge Employees who choose to cover their spouse in Riverside’s group medical plan and whose spouse is eligible for medical coverage with their employer will pay a $50 surcharge per pay period, in addition to the health insurance premium. The Spousal Surcharge will be waived if: Your spouse does not have medical coverage available through his/her employer Your spouse is unemployed, self employed, or retired Your spouse is covered by Medicare Your spouse is also employed by Riverside Medical Center If your spouse meets one of the criteria above, you must complete the exemption form electronically at www.benefitstalk.com/Riverside or complete and return to the Benefit Center by Fax (866) 932-6838 or mail to WestLake Financial Group, Inc., 1477 Barclay Boulevard, Buffalo Grove, IL 60089
  • 17. Tobacco SurchargeThe purpose of the Tobacco Surcharge Program is to provide additional motivation to encourage healthy lifestyles in our workplace environment. In addition to promoting healthy lifestyles, the surcharge will help cover additional health plan expenses generated by smoking and other tobacco related health problems. The surcharge applies only to employees enrolled in health insurance. $15 per pay period for each covered family member who uses or has used tobacco products within the past six months. To avoid the surcharge, you must enroll online at www.benefitstalk.com/riverside or contact the Benefit Call Center at (866) 932-6851 and indicate your tobacco-free status.
  • 18. Quit Smoking Help Riverside would like to help make it easier for you to quit by reimbursing you and your dependents the cost of the following smoking cessation programs and will also reimburse up to $100 for out-of- pocket expenses for quit smoking aids, such as medications, gum, patches, etc. Bring your receipts to Employee Health for reimbursement. Freedom From Smoking: Cost $30.00 (refunded to you upon completion) - American Lung Association program - 8 week series of weekly sessions at Riverside Medical Center. Sign up by calling 815- 935-7531. Smoking Consultation: Cost $25.00 (refunded to you upon completion) - Offered every 3rd Thursday of the month at Bourbonnais Plaza. Sign up by calling 815-935-7531. A one-on-one 30 minute consultation to get started and work independently based on tangible health data of fingerstick lipid profile and pulmonary function test. A respiratory therapist trained in smoking cessation will assist in you in your goals for successfully quitting. An RN will discuss your lipid profile results and benefits of quitting.
  • 19. More help to quit smoking…Other free smoking cessation programs that are available: Freedom From Smoking On-line program: FREE! Sponsored by American Lung Association On-line program to assist in quitting smoking. www.ffsonline.org Tobacco Hotline 24 hrs/day: FREE! An option for those that need to speak to someone periodically in their process of quitting. Experts are available 24 hours a day at 1-866-QUIT YES ( 1-866-784-8937) BCBS Blue Care Connection: FREE to employees enrolled in BCBS benefits! www.bcbsil.com Go to the Personal Health Manager and click the Stop Smoking button to enroll in the online program, or contact customer service.
  • 20. Opt Out InformationIf an employee has health insurance coverageelsewhere, they may OPT OUT of health insurance atRiverside and receive a benefit credit every payperiod.To receive this credit, you must… Provide proof of insurance each year. Fax or mail a copy of your insurance card to the Benefit Center (Fax: 866-932-6838) Please remember to put your name and employee ID number on anything you send to the benefit center. Participate in the REACH Employee Wellness Program to get the full credit.
  • 21. Flexible Spending Accounts (FSA)FSA’s are a way to save money by paying for certain health anddependent expenses with before tax dollars.You must elect your contribution amount each year (the IRSprohibits the automatic rollover of FSA elections from year to year)Go to the BenefitsTalk™ website to access balances and viewrecent transactionsGrace period extends thru March 15, 2012 to incur expenses.Deadline to submit 2011 claims is April 15, 2012, to WestLake. Use-It-Or-Lose-It Rule still applies Manual claims processed within 48 hoursYou will also have the option to use the Debit Card. Approvedexpenses are automatically deducted from your pre-tax account. You may continue to use the same card from last year
  • 22. Dependent Eligibility Verification (DEV) Employees who are adding new dependents to their medical, dental, or vision plan, are required to submit proof of eligible status to the Benefit Center by December 10. Documents that are acceptable include, birth certificates, marriage certificates, tax returns, etc. A full list of acceptable documents is available online. Please remember to put your name and employee ID number on anything you send to the benefit center.
  • 23. Riverside In-Network PhysiciansFor a better level of coverage, employees maychoose from physicians in the Riverside In-NetworkPhysician List. $30 co-pay per office visit $40 co-pay for specialists 90% coverage (after deductible) for inpatient visitsAn updated list is available… online at www.benefitstalk.com/riverside on RiverNet (in the Benefit Folder under Human Resources) or from Human Resources
  • 24. Prescription Plan $10 co-pay for generics $40 co-pay for formulary brand names $60 co-pay for brand names and injectibles Use Riverside Family Pharmacy and get a three month supply of maintenance drugs for… TWO co-payments in the Preferred Plus Plan and Preferred Plan ONE co-payment in the Basic Plan
  • 25. Prescription Drug ProgramsPrescription drugs are getting more expensive everyyear. As part of our effort to provide the most healthcarefor our dollars for both employees and our organization,three prescription programs are in place. Generic Drug Utilization – This program is to increase generic drug utilization. A generic medication on average will cost 30% to 80% less than the equivalent brand-name drug. Step Therapy Program - This program is all about getting a proven safe and effective drug for your condition, and getting it at the lowest possible cost. Prior Authorization Program - The program monitors certain prescription drugs and their costs so that you can get the right drug at the right cost. It works much like a health plan that approves some medical procedures beforehand, to make sure you’re getting the tests you need.
  • 26. Riverside Health Fitness CenterRiverside will continue to offer employees monthlymembership at half price with a reduced enrollmentfee of $50 for new employee members.Riverside will pay 50% of monthly membership forthe first family member (i.e. spouse or dependent)and the enrollment fee will be $75. This also applies if the second family member is enrolling in the Fitness Island Membership programTo receive discounts, employees must pay throughpayroll deduction, commit to a one yearmembership, and be a 0.5 FTE or greater
  • 27. Enrollment ProcessLog on to the BenefitsTalk™ website atwww.benefitstalk.com/riversideReview online plan informationReview your current electionsProcess your enrollment for 2012 by Nov. 23Benefit Call Center representatives areavailable toll free at (866) 932-6851 Monday through Friday from 7AM-11PM and from 7AM-NOON on Saturday.