Cuyahoga County. Agenda. Open Enrollment. What s New, What s the Same. Voluntary Benefits How To Enroll Questions

Transcription

1 Open Enrollment

2 Cuyahoga County Open Enrollment 2012 Agenda Open Enrollment What s New, What s the Same Healthcare Reform changes Voluntary Benefits How To Enroll Questions 1

3 Open Enrollment 2

4 Open Enrollment Open Enrollment is between October 31 st and November 18 th YOU MUST ACTIVELY ENROLL IN ORDER TO GET THE PLAN OF YOUR CHOICE Employees who do not enroll, will be enrolled in the MetroHealth Select Concierge Plan, but will miss out on other options Please contact Benefits if you have questions. nt s 3

5 Online Instructions Benefits Open Enrollment Instructions for In your web browser, enter the location of the web address for the Open Enrollment process. That address is Once you have typed this information into the address box, hit the enter key on your keyboard. Your login ID and password are necessary in order to enroll on-line. 4

6 Confirmation 5

7 What s New? What s The Same? 6

8 Open Enrollment 2012 WHAT S THE SAME? Your Current Provider Options are the Same United Healthcare Guardian - Dental Medical Mutual CareMark Prescription Drug Mt MetroHealth Select Sl Ki Kaiser Classic Union Eye Care Vision YOU MUST ACTIVELY ENROLL IN ORDER TO GET THE PLAN OF YOUR CHOICE 7

9 Open Enrollment 2012 WHAT S THE SAME MetroHealth Options MetroHealth Select Concierge remains the free plan for all employees MetroHealth Select Concierge continues to utilize both the MetroHealth pharmacies and CVS CareMark prescription drug program BUT ALL MAIL ORDER CAN ONLY BE AT METRO PHARMACIES (MAIN & HEALTH CENTERS) Metro Health Select Concierge maintains the $0 Deductible component and no changes to the benefit structure Appointment Line = Appointment within 5 days 8

10 Open Enrollment 2012 WHAT S THE SAME? Guardian Dental Plan No Change Vision No Change Basic Life/AD&D Insurance No Change FSA Plans YOU MUST RE-ENROLL EACH YEAR No Over The Counter items are eligible ibl for reimbursement due to Healthcare Reform 9

11 TERMINOLOGY NEW PLANS Deductible - The upfront amount you will pay to satisfy medical bills before the insurance kicks-in. Coinsurance - Percentage of medical charges you will have to pay. For in-network that is 10%. Up to a Maximum Out of Pocket - When you reach this amount you are covered at 100%. Copays - A flat amount that you pay at the time of a medical service to receive a medication or pay for a portion of the doctor s visit. 10

12 Open Enrollment 2012 WHAT S NEW? Benefit Modifications UHC, MMO SuperMed, Kaiser In-Network Component Current Change $0 Deductible $250/$500* 100% Coinsurance 90% $0 Out of Pocket Max $1,500/$3,000** Office Visits it All = $20 PCP = $15 Specialist = $25 Rx Retail = $10/$15/$30 Rx Retail = $5/$25/$40 Rx Mail = $20/$30/$60 Rx Mail = $10/$50/$80 * $250/Family member within the family ** $1,500/Family member within the family 11

13 How Does a Deductible Plan Work??? Example (In- NetworkDeductible Portion): John Doe has family coverage for his wife, Sally, and daughter with SuperMed (MMO) The Family Annual Deductible = $500 Costs Incurred during the plan year: X-ray = $300 ($250 satisfies the deductible) for John Crutches = $100 for Sally Insulin Pump = $150 for Sally Total = $500, which h satisfies John s and Sally s individual deductibles of $250 each The Deductible is not included d in the out-ofpocket maximum of $3,000 for family. 12

14 How Does a Deductible Plan Work??? Example (Coinsurance Portion In Network): John Doe has family coverage for his wife and daughter with SuperMed (MMO) The Family Annual Deductible = $500, has been met, so now the benefits of a 90% coverage plan kicks-in. Costs Incurred for an Apnea Monitor costing $1,000 and is in-network: Plan Pays = $900 John Doe Pays = $100, which now lowers the out of pocket from $3, Note: Copays and routine RX do not go towards the deductible or out-of-pocket maximum. 13

15 Open Enrollment 2012 WHAT S NEW? Benefit Modifications UHC Out-of-Network Component Current Change $300 Deductible per Covered $500/$1,000 Person 70% Coinsurance 70% $3,000 Out of Pocket Maximum $3,000/$6,000 per covered person 70% Covered 70% Covered Rx Retail = $10/$15/$30 Rx Retail = $5/$25/$40 Rx Mail = $20/$30/$60 Rx Mail = $10/$50/$80 MMO SuperMed, Kaiser Classic and MetroHealth Select DO NOT HAVE an out-of-network component. 14

16 Open Enrollment 2012 WHAT S NEW? Benefit Modifications United Healthcare Change Current 90% Plan to an 80% Plan Current Change $250/$500 Deductible $500/$1, % Coinsurance 80% $1,500/$3,000 Out of Pocket Max $2,500/$5,000 PCP Office Visit= $15 PCP = $20 Specialist = $25 Specialist = $30 Rx Retail = $10/$15/$30 Rx Retail = $10/$25/$40 Rx Mail = $20/$30/$60 Rx Mail = $10/$50/$80 15

17 Healthcare Reform Changes 16

18 Healthcare Reform Changes Dependent Eligibility MEDICAL COVERAGE ONLY!!! Dependents up to age 26 can be added to the plan Do not have to be a Full Time student t Can be married or unmarried (spouse and/or children not eligible) Dependents up to age 28 can be added under State legislation Have to be a resident of Ohio, or a FT Student if residing outside of Ohio Cannot be married Cannot have coverage available at current job Employees will pay a separate fee, which will be disclosed at Open Enrollment, in order to add age dependents DOCUMENTATION MUST BE SUBMITTED ANNUALLY DENTAL/VISION COVERAGE IS ONLY UP TO AGE 23 17

19 Plan Changes Wellness Incentive Program Completing healthy habits allows you to earn dollars to reduce your deductible on all plans, except for Metro Health. A chance to earn the $300 MetroHealth Incentive by engaging in healthy habits. Health Reimbursement Account Employees responsible for deductibles they do not earn down. 18

20 Wellness Platform (Engine) RFP Currently out on the Wellness Platform Incentive Based System that: Is HIPAA Compliant Web Based System Calculates & Keeps Track of Points for Healthy Activities Has Wellness Tools Health Risk Assessment Pedometers Customer Service Support To Be Determined Once a Vendor is Selected 19

21 Wellness Platform How Does It work MetroHealth Select (non-deductible program) - Earn wellness points to obtain the MetroHealth incentive Other Medical Coverage (deductible programs) Earn wellness points to reduce deductible 20

22 Plan Changes Non-Smoker Incentive Non-Smokers will gain points toward their deductible Smokers provided with compliance period of August 1 st until January 1 st to quit Two Months of Smoking cessation products to be provided to employees at no cost. County migration to non smoking campus 21

23 Flexible Spending Accounts - FSA Medical Reimbursement Account A way to set aside money on a pre-tax basis to reimburse yourself for eligible out-of-pocket of medical expenses for you and your dependents. Examples of Eligible Expenses Deductibles Copays py Prescription Copays Dental and Vision so expenses Maximum Annual contribution: $2,080 **Even if you (or spouse and kids) are not on the County Health Insurance plan. 22

24 Flexible Spending Accounts - FSA An IRS-approved method of paying for your out-ofpocket medical expenses pre-tax. Debit cards are available Medical Only Over The Counter Drugs are no longer eligible for reimbursement unless you have a prescription. Useitorloseitprovision 23

25 Flexible Spending Accounts - DCA Dependent Care Reimbursement Account Set aside money on a pre- tax basis to reimburse yourself for eligible dependent care expenses. Dependent Care must be for a Qualified Tax dependent (dependents over age 13 NOT ELIGIBLE). Go to IRS website for definitions of qualified tax dependent Services must be provided in the plan year, and you must provide the name, address, and Tax ID Number or SSN of provider in order to be reimbursed. (Day Care, After School Care program, in home provider must provide SSN!!) Maximum Annual contribution: $5,000 24

26 Transportation Pre-Tax Benefit Deduct Work Related Parking and RTA bus passes Employees can have the cost of RTA passes or the cost of county owned lots deducted from payroll warrants and forwarded on your behalf to the appropriate department for processing. Employees must elect the amount they wish to have deducted for Non-County owned lots. Employees must then submit a claim form for reimbursement You can change your deduction at any time You can only be reimbursed up to the amount you have deducted each payroll. Balance roll over month-to-month and year-to-year y as long as you are an active employee. 25

27 Voluntary Benefits 26

28 Unum Individual id Voluntary Benefits Available: Life Insurance, Accident, Critical Illness and Short Term Disability for policy & claims issues to enroll or dis-enroll 27

29 Voluntary Benefits HOW TO GET ENROLLED Enroll On-Line: Click the Voluntary Benefits Hot Link and a representative will contact you to discuss the benefits. IF YOU CURRENTLY HAVE VOLUNTARY BENEFITS Benefits will continue UNLESS you cancel them directly with UNUM. To cancel you must sign up on the link and a representative will then contact you to discuss. 28

30 Open Enrollment OCTOBER 31 st NOVEMBER 18TH Open Enrollment is between YOU MUST ACTIVELY ENROLL IN ORDER TO GET THE PLAN OF YOUR CHOICE Employees who do not enroll, will be enrolled in the MetroHealth Select Concierge Plan. After you complete the on-line enrollment, PRINT YOUR CONFIRMATION Appeals must be done by December 6 th. NO APPEALS WILL BE CONSIDERED PAST DECEMBER 6 th!! Please contact Benefits if you have additional questions. benefits@cuyahogacounty.usus 29

31 Charity Choice 30

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33 QUESTIONS? 32