Mid Year Open Enrollment for Certain Medical Plans and Introduction of Sutter Health
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1 Mid Year Open Enrollment for Certain Medical Plans and Introduction of Sutter Health Effective: March 1, /4/16 1
2 NEW SUTTER MEDICAL PLAN What Happened? Starmark final rate increase was significant/unaffordable Sutter Health identified as option Employees affected voted to move to Sutter 3/1/16 (Eliminating Starmark) Blue Shield Plan extended to 2/29/16 What does this mean to me? Eligible Employees will have ability to change medical plans on 3/1/16 From Kaiser/Blue Shield to Sutter Blue Shield to Kaiser Cannot change within Kaiser Plans (Not a qualifying event) What does this mean for the School? Provides a viable, high quality, affordable alternative to Kaiser Maintains carrier, and introduces additional plan, choices for employees 2/4/16 2
3 SUTTER HEALTH CARE OVERVIEW Not For Profit Health Care Not a PPO (Compete With Kaiser/HMO) No out of network coverage Network includes Palo Alto Medical Foundation Clinics No Health Care Questionnaires required to establish first year premiums Requires a minimum of 10% of employee Health care enrollment (15 employees) Over 20,000 members throughout their coverage area. Committed to high quality care (both primary and specialty care) at an affordable price 2/4/16 3
4 SUTTER HOSPITAL NETWORK 2/4/16 4
5 SUMMARY PLAN COVERAGE Plan Ends 2/29/16 Plan Begins 3/1/16 Kaiser HSA 4302 Kaiser HRA 4457 Kaiser $0 Blue Shield HSA Sutter Health Plus H.S.A. Sutter Plus HMO In Network Only In Network Only In Network Only In Network Out of Network In Network In Network Deductible Individual $2,700 $1,500 $0 $2,250 $2,500 $0 Family $5,450 $3,000 $0 $4,500 $5,000 $0 Out of Pocket Maximum Individual $2,700 $3,000 $1,500 $3,000 $6,000 $4,000 $2,500 Family $5,450 $6,000 $3,000 $6,000 $12,000 $8,000 $5,000 Coinsurance 100% 20% 0% 20% 50% 20% 0% Funding Individual $1,750 $2,000 N/A $1,750 $1,750 N/A Family $3,500 $4,000 N/A $3,500 $3,500 N/A Physician Services Office visit 0% after ded. $20 after ded. $10 20% after ded. 50% after ded. 20% after ded. $25 Lab/X ray 0% after ded. $10 after ded. $0 20% after ded. 50% after ded. 20% after ded. $50 Preventive no charge no charge no charge no charge not covered no charge no charge Hospital Services Inpatient 0% after ded. 20% after ded. no charge $ % after 50% after ded. 20% after ded. $500 per day up to 5 days Outpatient 0% after ded. 20% after ded. $10 20% after ded. 50% after ded. 20% after ded. $10 per visit Emergency 0% after ded. 20% after ded. $50 $100 per admit + 20% 20% after ded. $150 per admit Prescriptions 30 day supply 30 day supply 100 day supply Generic $0 after ded. $10 $10 $10 after ded. 25% of charges $10 copay after ded. $10 Brand $0 after ded. $30 $10 $25 after ded. plus applicable $30 copay after ded. $30 Non Formulary not covered not covered not covered $40 after ded. copay $60 copay after ded. $60 2/4/16 Specialty $0 after ded. $30 $10 30% after ded. Not covered 20% after ded. 20% after ded. 5
6 HEALTH PLAN CONTRIBUTION MATRIX Annual Premiums Kaiser HRA Kaiser HSA Kaiser Blue Shield Sutter HSA Sutter $0 Ded ($1,500/$3,000) ($2,700/$5,450) ($0 Ded) ($2,250/$4,500) ($2,500/$5,000) $0 Ded Employee CY15 CY16 CY15 CY16 CY15 CY16 CY15 CY 16 CY 16 Total Premium $ 5,561 $ 5,574 $ 6,540 $ 6,566 $ 7,539 $ 7,903 $ 9,606 $ 5,717 $ 7,254 School Premium Contribution 5,410 5,422 5,660 5,672 7,410 7,422 5,660 5,672 7,422 School HRS/HSA Contribution 2,000 2,000 1,750 1,750 1,750 1,750 Total School Contribution 7,410 7,422 7,410 7,422 7,410 7,422 7,410 7,422 7,422 Employee Contribution , Per Paycheck (24 per year) $ 6.29 $ 6.31 $ $ $ 5.38 $ $ $ 1.86 $ Employee +1 (Spouse Starmark) Total Premium 11,123 11,916 13,079 13,131 15,078 15,805 20,767 11,433 14,508 School Contribution 10,520 11,271 11,020 11,771 14,520 15,271 11,020 11,771 15,271 School HRS/HSA Contribution 4,000 4,000 3,500 3,500 3,500 3,500 Total School Contribution 14,520 15,271 14,520 15,271 14,520 15,271 14,520 15,271 15,271 Employee Contribution ,059 1, ,747 Per Paycheck (24 per year) $ $ $ $ $ $ $ $ $ Employee +1 (Children Starmark) Total Premium 11,123 11,916 13,079 13,131 15,078 15,805 20,767 11,433 14,508 School Contribution 10,520 11,271 11,020 11,771 14,520 15,271 11,020 11,771 15,271 School HRS/HSA Contribution 4,000 4,000 3,500 3,500 3,500 3,500 Total School Contribution 14,520 15,271 14,520 15,271 14,520 15,271 14,520 15,271 15,271 Employee Contribution ,059 1, ,747 Per Paycheck (24 per year) $ $ $ $ $ $ $ $ $ Family Total Premium 15,738 16,861 18,507 18,581 21,336 22,364 29,395 16,178 20,529 School Contribution 15,001 16,071 15,501 16,571 19,001 20,071 15,501 16,571 20,071 School HRS/HSA Contribution 4,000 4,000 3,500 3,500 3,500 3,500 Total School Contribution 19,001 20,071 19,001 20,071 19,001 20,071 19,001 20,071 20,071 Employee Contribution $ 737 $ 790 $ 3,005 $ 2,010 $ 2,335 $ 2,293 $ 13,894 $ $ 458 Per Paycheck (24 per year) $ $ $ $ $ $ $ $ $ CY15 Increased HRA and HSA funding by $500 per individual, $1,000 +1, Family. 2/4/16 6
7 CHANGING PLAN TYPES/HSA FUNDING Key Points: Changes within Kaiser are not permitted (not considered a qualifying event) Plan Deductibles: If you change plans (other than HSA to a HSA Plan) deductibles are not transferrable Traditional FSA (medical) elections: Moving from a Non HSA Plan to an HSA Plan FSA Elections will automatically end after 2/29/16 HSA Contributions not permitted until FSA benefit is exhausted Moving from an HSA Plan to a Non HSA Plan FSA Elections cannot be changed for balance of calendar year Employees that did not previously elect a FSA are eligible to enroll/elect a traditional FSA We will set aside time at the end of the meeting for individual questions regarding deductibles and/or FSA/HSA elections. HSA Funding: The school will fund 4 months of the annual HSA allowance in March for those enrolled in a HSA plan, the final 6 months in July. This was previously communicated. 2/4/16 7
8 SUMMARY Premiums: With the introduction of Sutter after our annual open enrollment, most Sutter plans will result in 100% employer premium coverage for the March though Dec 2016 period. This is a one off/solely due to the mid year Sutter introduction. Key Dates: Our employee benefits are based on all medical plans (including Sutter) requiring a employee premium co payment. This will be the case when hold our next open enrollment for calendar year Open Enrollment Friday, Feb 5, 2016 thru Friday, Feb 19, 2015 New Plans Effective Tuesday, March 1, 2016 Points of Contact: Yvonne Denison, x 228 Laura Cross, Filice Insurance (925) , laura@filice.com Questions? 2/4/16 8
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This is an advertisement. Your 2017 guide to choosing a Kaiser Permanente MEDICARE health plan INCREASE YOUR COVERAGE without increasing your FEHB monthly premium* Kaiser Permanente Senior Advantage for
Your 2017 guide to choosing a Kaiser Permanente MEDICARE health plan
This is an advertisement. Your 2017 guide to choosing a Kaiser Permanente MEDICARE health plan INCREASE YOUR COVERAGE without increasing your FEHB monthly premium* Kaiser Permanente Senior Advantage for
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2015 BENEFITS GUIDE We are pleased to announce that we will be renewing our medical and pharmacy benefit plans with Florida Blue for 2015. This Benefit Guide provides important information and details