IAM Annual Enrollment April

Transcription

1 IAM Annual Enrollment April

2 What s Changing for 16/17? Annual Enrollment will be ACTIVE again this year Annual Enrollment dates are May NEW Medical/Rx Options 1low deductible plan, 3 qualified high deductible plans Up front funding to Health Savings Accounts (HSAs) in the 3 qualified plans Default for failure to enroll will be the Green with no HSA, dental or vision coverage 3Dental plan options 3 Vision plan options Core and Enhanced Options Discover, Join & Be 2 Rewarded

3 Network Choices The Yellow runs on the same network as the existing Core To receive maximum in-network benefits your care must be directed by your Primary Care Physician The Green, Blueand Oranges run on the same network as the existing Enhanced and HealthSaver s You are not required to get a referral from your Primary Care Physician to see a Specialist New for 2016/2017 Coventry is merging with Aetna. You may receive a new medical ID card in the mail in June 2016 Catamaran Rx has merged with Optum Rx. You may receive a new Rx ID card in the mail in June 2016 If you or a covered family member have a prescription impacted by the change you will be contacted by Optum Rx New HSA Bank all Spirit contributions will be made to HSA Bank. If you already have an HSA setup with HealthEquity or Optum Bank you may roll that money over into a new account with HSA Bank 3

4 Spirit Medical Options AE Video Medical Deductible Max Out-of-Pocket(OOP) (including Deductible and RX) Premium Holiday SpiritHSA Seed $ Core $5,350/single;$10,700/family Personal Care Account $ Enhanced $1,000/single;$ 2,500/family Embedded $2,000/single;$4,500/family $500/single; $1,000/ee+; $1,500/family Yellow $500/single; $1,000/family Embedded $2,400/single;$4,800/family 3 months Green $1,500/single; $3,000/family True Family $3,000/single;$6,000/family 6 months $750/Single; $1,500/Family Blue $2,500/single; $5,000/family True Family $4,500/single;$6,850/family 6 months $750/Single; $1,500/Family Orange $4,500/single; $9,000/family Embedded $6,550/single;$13,100/family 6 months $750/Single; $1,500/Family 4

5 Big Savings $ Premium Holidays means a break from the medical premium $ The Yellow has a 3 month premium holiday $ The Green, Blue & Orange s have a 6 month premium holiday Yellow (total 3 mos. Savings) Green (total 6 mos. Savings) Blue (total 6 mos. Savings) Employee $221 $308 $65 Employee + $442 $615 $130 Family $663 $923 $195 $ The Savings grow bigger on the Green, Blue & Orange s with HSA Seed Dollars $ $750 for employees enrolled in employee only coverage $ $1,500 for employees enrolled in employee + or family coverage $ Seed dollars are deposited into your HSA the first pay period of July $ This is your money to spend on eligible medical expenses, or save for the future To maximize savings, put these dollars into your HSA! Discover, Join & Be Rewarded 5

6 Comparing Rates Wichita IAM Single 2015/2016 Rates (Include Vision) Employee + Family Single 2016/2017 Rates (Exclude Vision) Employee + Family Core $41.70 $83.40 $ Enhanced $13.75 $27.50 $41.25 Core $58.23 $ $ Enhanced $14.39 $28.78 $43.18 HealthSaver $12.65 $25.35 $36.25 Basic Value $0.00 $0.00 $ /2017 s and Rates (Exclude Vision) Yellow Green Blue Orange Employee $36.82 $25.64 $5.41 ($16.68) Employee + $73.64 $51.28 $10.84 ($33.35) Family $ $76.91 $16.26 ($50.03) Identified Rates are Pay Period Rates Lifestyle Based Premium Rates are not reflected 6

7 Group Hospital Indemnity (offered through Employee Benefit Systems, EBS) Who needs Hospital Indemnity insurance? I thought my medical insurance covered my costs. - Your medical insurance covers many of the costs associated with a hospital stay and inpatient treatment, but what you may not know is that you could still be left with significant out-of-pocket expenses such as: The obvious: Medical insurance deductibles Medical co-pays; hospital care co-pays; coinsurance and prescription drug co-pays Rehabilitation Alternative treatments The not-so-obvious: Childcare Transportation to health facilities Diagnostic tests EBS Enrollers are onsite to help you enroll 7

8 Group Hospital Indemnity Covered health events and lump-sum benefits What are my benefits under this plan? Guarantee Issue No Pre-Existing Exclusions $1,000 for each covered hospital admission (one payment per insured per calendar year) $100 for each day of your covered hospital stay, up to 15 days (one payment per insured per calendar year) Employee Cost Per Paycheck Age Employee Employee & Spouse Employee and Child Employee, Spouse and Child $7.21 $12.92 $10.29 $ $10.14 $20.27 $13.22 $ $14.47 $30.24 $17.55 $ $20.78 $43.18 $23.86 $

9 Group Critical Illness What is covered under this Group Critical Illness? Advantages A benefit can be paid for each covered condition Employee-paid coverage is portable Dependent children are automatically covered at 25% of the employee benefit amount Additional diagnosis benefit Multiple payouts automatically included in the plan design Each condition payable once per lifetime per covered individual (except for benign brain tumor, heart attack, cancer and stroke) Additional benefits payable for diagnosis of another critical illness if separated by 90 days or more and medically unrelated EBS Enrollers are onsite to help you enroll 9

10 Group Critical Illness Who needs Group Critical Illness insurance? Covered conditions Blindness Benign brain tumor Coronary artery bypass surgery* End-stage renal (kidney) failure Heart attack Major organ failure Stroke* Covered conditions due to injury Coma Permanent paralysis Occupational HIV Cancer coverage included Cancer Carcinoma in situ** Specific childhood conditions Cerebral palsy; cleft lip or palate; cystic fibrosis; Down syndrome; spina bifida Employee Cost Per Paycheck Cost Example for a $15,000 Benefit Issue Ages Rates < $ $ $ $ $ $77.72 **100% of the benefit payable for each covered condition, with the exception of coronary artery bypass surgery and carcinoma in situ, which are paid at 25% of the purchased benefit amount. Please see policy definitions for complete details about these covered conditions. 10 Guarantee Issue No Pre-Existing Exclusions *Please note rates are illustrative and may change due to rounding differences.

11 Dental s New Dental Options Annual Deductible Single Family Premier $25 $75 Standard (PPO) Basic Plus $50 $150 Preventive Services 100% 100% 100% Annual Maximum Per Person $1,500 (some restrictions) $1,000 Basic Services 80% 100% 50% Major Services 50% 100% 50% Orthodontia Services 50% 50% No Benefit Orthodontia Lifetime Maximum $1,750 $1, New s Premier Employee Only Standard (PPO) Basic Plus $1.85 $5.97 $0 Employee + $3.71 $11.93 $0 Family $5.56 $17.90 $0 Displayed rates are pay period rates

12 Vision s All Populations New Vision Options Enhanced Basic Exam Only Eye Exam Copay (Limited to one time per year) Lenses (Limited to once every 12 months) $20 $20 $10 Benefit/Coinsurance 0% 0% 0% (Limited Benefit Standard Lenses) Frames or Contacts in lieu of lenses/frames (Limited to onceevery 12 months) (Limited to onceevery 24 months) () New s Enhanced Basic Employee Only $2.98 $0.59 $0 Employee + $5.95 $1.17 $0 Family $8.94 $1.76 $0 Exam Only Frame Allowance Contact Allowance (Conventional or Disposable) $210 $210 $135 $135 Discounted Discounted 12 Displayed rates are pay period rates

13 Final Things to Remember Annual Enrollment will be ACTIVE again this year Annual Enrollment dates are May 3 13 Enrollment will be through the benefits website, by phone, we will also again have mobile enrollment carts and computer lab hours available EBS enrollers are on site to discuss and help you enroll in Critical Illness and/or Hospital Indemnity Coverage Employees will receive reminder mailers at their home address Discover, Join & Be Rewarded 13