Benefits Forum. Annual Open Enrollment for 2016

Transcription

1 Benefits Forum Annual Open Enrollment for 2016

2 GRMC Benefits Open Enrollment Value-Added Benefits Celebrate our Successes! What s New in 2016? Choice Plan Out of Pocket Maximum / Family HSA Maximum Contribution Increase Wellness Incentives Pharmacy Copay Changes Short and Long-Term Disability Insurance Employee Toolkits Schedule of Events Open Enrollment timeline, forums, fair, departmental assistance Online Enrollment Support and Tips Flu Clinic Time

3 Value-Added Benefits GRMC provides competitive benefits and contributes a good portion towards benefits in general. Health Insurance $14,300,000 Approx 60 70% of the total cost The portion your employer paid towards Employee Benefits in FY15 Retirement Savings $10,000,000 Dollar for dollar up to 5% Disability (STD/LTD) $ 1,200,000 ER pays 50% Option; EE pays cost difference for 60% Option Life Insurance $ 360,000 ER pays 100% of 1X Basic Life/ADD $25,860,000 Your benefits are part of your total compensation package, and, Human Resources benchmarks salaries of staff to advance the competitiveness of our compensation program.

4 Celebrate our Successes Georgia Regents Medical Center (GRMC) is designated as an American Heart Association Fit-Friendly Worksite - the first hospital in the C.S.R.A. to receive this special designation. The AHA recognizes employers as Fit-Friendly Worksites for creating a culture of wellness in the workplace and providing progressive leadership in employing healthy practices in the workplace. The CEO Roundtable on Cancer has accredited GRMC with the CEO Cancer Gold Standard, recognizing the hospital s efforts to reduce cancer risk for employees and covered family members.

5 Celebrate our Successes Calendar Year 2014 Paid Medical claims dropped by 5% Paid Per Member Per Month decreased (-10%) ER visits trending downward from prior year (-.8%) Office visits trending down from prior year (-4.9%) Lab services trending down from prior year (-.2%) Radiology services trending down from prior year (-.9%) Admits per 1,000 down from prior year (-.2%) Readmission rate down from prior year (-2.8%) High cost claims per member down from prior year (-25.2%) Self-Funded Health Plan - Things to Continue Watching in 2015 Inpatient days per 1,000 are trending up from previous year (+4.2%) Inpatient average length of stay trending up from previous year (+4.4%) The total cost of Rx increased (+10.9%) No Health Plan Premium Increases in 2016!

6 What s New in 2016 Choice (High Deductible Health Plan) Deductible In-Network UHC Network - Individual $1,500 $2,000 - Family $3,000 $4,000 Medical Out-of-Pocket Maximums (including deductible) In-Network UHC Network - Individual $4,500 $6,000 - Family $9,000 $12,000 The most any one individual in the Family option will pay out of pocket in 2016 is $6,550!

7 What s New in 2016 Health Savings Accounts Annual Contribution Limits Individual Coverage $3,350 $3,350 - Family Coverage $6,650 $6,750 If you are age 55 or older, you may make annual catch-up contributions of up to $1,000. After the first payroll of 2016, GRMC will contribute $500 in to Individual HSA s and $875 in to Family HSA s.

8 Cost Population Risk Distribution Risk Groups Healthy: Generally healthy, many do not use any healthcare services. Stable: Also healthy, but most utilize healthcare services. Low risk to become high cost, but could benefit from monitoring. The healthiest 32.6% of members account for 1.6% of costs The sickest 2.3% of members account for 34.7% of costs 50% 40% Prior Period At Risk: Fairly heavy utilizers of the healthcare system, but conditions are not yet very severe. Their health has some influence on their day-to-day life, but is still manageable. At risk for becoming high cost. 30% 20% 10% Current Period Norm Struggling: Heavy utilizers of the healthcare system. Likely to have a chronic condition and have their health significantly influence their dayto-day life. High risk for extreme costs unless managed. 0% 50% 40% Healthy Stable At Risk Struggling In Crisis Prior Period In Crisis: Extremely heavy healthcare utilizers who incur peak costs. Frequently have multiple chronic conditions and severe acute episodes. 30% 20% 10% Current Period Norm 0% Healthy Stable At Risk Struggling In Crisis 8

9 Preventive Screenings & Well Visits Adults (Screening Rate) 70% UMR Norm 60% 50% 40% 30% 20% 10% 0% Well Visit Mammogram Cervical Cancer Prostate Cancer Colon Cancer Cholesterol * Screening recommendation age limit the data is limited to members under 65 9

10 Preventive Mammograms

11 Maternity Management Currently a $25 gift card is provided to plan members who enter the Maternity Management Program. Effective July, 2015, a $100 gift card is being provided. The member must enroll during the 1 st trimester and stay in the program thru delivery.

12 Wellness Incentives for Choice HDHP Participants GRU Healthy You Wellness Incentives for Choice HDHP Participants HSA Seed HSA Incentives Both the Clinical Health Risk Assessment and Biometric screening will continue to be required and both must be completed to earn wellness incentive dollars Timeline for completion: November 1, 2015 May 31, 2016 Health Risk Assessment Biometrics Two HSA payouts in 2016 July and October $500 (Individual) $875 (Family) Employer will provide up to an extra $500 in wellness incentives $100 35% of employees in the Choice HDHP are participating! Potential payout - $183K If all participated - $533K

13 Wellness Incentive Updates for 2016 HSA $$ Education Complete contractual weight loss program (i.e. WW, PHC, etc.) (limit 1 time per year) 50 UMR Maternity Management Program 25 Preventive Care PSA/Prostate Screening (for men age 40+) 100 Colorectal cancer screening over age

14 Pharmacy Benefit Changes In-Network Provider Employee Pharmacy Out-of-Network Provider Employee Pharmacy Retail Pharmacy Days Supply 30 day supply / 90 day 30 day supply / 90 day 30 day supply $ % to a max Tier 1 Tier 2 Tier 3 Specialty (30 day supply only) $5 / $10 $10 / $20 $10 / $20 $20 / $40 $15 / $30 (2015) $30 / $60 (2016) $30 (2015) $50 (2016) $30 / $60 (2015) $40 / $80 (2016) $60 (2015) $80 (2016) of $450 $ % to a max of $450 Must fill at GRMC Employee Pharmacy Must fill at GRMC Employee Pharmacy

15 What s New in 2016 Short-Term Disability Insurance New Carrier Mutual of Omaha Current Rate Structure 2016 Rate Structure 50% Option 60% Option 50% Option 60% Option Rate per $10 of weekly benefit $.494 $.61 Rate per $10 of weekly benefit $.421 $.61 Long-Term Disability Insurance Current Rate Structure 2016 Rate Structure 50% Option 60% Option 50% Option 60% Option Rate per $100 $.203 $.67 Rate per $100 $.177 $.67

16 What s New in 2016 Disability Plan Design - Reminder STD Plan Design LTD Plan Design 50% Option 60% Option 50% Option 60% Option Elimination Period 14 Days 7 Days Elimination Period 120 Days 90 Days Duration of benefit 12 Weeks 12 Weeks Duration of benefit 4 Years SSNRA Max weekly benefit $1,000 per week $1,500 per week Max monthly benefit $6,000 $6,000 Portion paid by GRMC 100% 50% option portion (employee pays cost difference) Portion paid by GRMC 100% 50% option portion (employee pays cost difference) STD/LTD benefits have a waiting period of one year and a day.

17 17 Employee etoolkit All materials will be available on the PAWS, GRMC Benefits website at Information.aspx

18 GRMC Schedule of Events Open Enrollment Thursday, October 1 to Friday, October 16 Benefits & Services Fair CHOG Conference Center BT-1810 Times 10:00 AM 4:00 PM Oct 1 Manager Benefit Forums All meetings held in the Lee Auditorium BC 1040 Times 8:00 AM 9:00 AM Sept 10 Sept 15 Staff Benefit Forums All meetings held in the Lee Auditorium BC 1040 Times 7:30 AM 8:30 AM 11:30 AM 12:30 PM 3:30 PM 4:30 PM Sept 23 Sept 24 Sept 29

19 Benefits & Services Fair The following vendors and Georgia Regents service groups may be available to talk to staff about services and benefits offerings, and answer questions! Ascension Bank of America (FSA/HSA) Colonial GRMA Concierge Services Delta Dental Employee Pharmacy Employee Health Employee Assistance Program Employee Discount Program EyeMed Vision The Family Y GRU Cancer Center GRU Equality GRU Wellness Center HCCU Hyatt Legal Long-Term Care Insurance Mutual of Omaha Office of Advancement Patient and Family Engagement The Standard Life Travelers Home/Auto UMR Valic VPI Pet Insurance Weight Watchers

20 Enrollment Support Triage: Web: On-Site Assistance: Human Resources on Pope Avenue Phone System :30 am 5 pm (Monday Friday) (GENERAL) (TECHNICAL) (PLAN SPECIFIC) Questions When is open enrollment, benefit fair date, employee meetings, etc.? How do I enroll? Do I have to enroll? How do I access Employee Self Services)? What is my password? I m getting an error message. What next? What are my plan options? What is a HSA? How do I use my FSA? Which medical plan is best for me? Where can I find additional information?

21 Departmental Support GRMC Benefits offers departmental support/service Call to set up departmental meeting with a Benefits representative Your Employee Engagement Results at Work!!!

22 Help Us Help You Everyone benefits-eligible must enroll To inform us of HSA or FSA contributions in 2015 To update the spousal surcharge attestation To update the non-tobacco usage attestation To add/delete or modify any benefit plan Everyone who has a spouse and/or child(ren) on their health benefit plan must Add the dependent s social security number in Employee Self Services, Open Enrollment section (if SSN is missing or incorrect) New federal tax filings beginning early 2016 Filings to the IRS and statements to employees AIR Affordable Care Act Information Returns 1094-C (Transmittal of Employer-Provided Health Insurance Offer and Coverage Information Returns) 1095-C (Employer-Provided Health Insurance Offer and Coverage)

23 Helpful Online Enrollment Tips Use Internet Explorer as Your Browser Disable Pop-up Blockers Place ESS in Compatibility Mode Recovery of Password

24 Employee Flu Shot Dates September 15 November 20 Monday Friday 7 a.m. to 5 p.m. Employee Health & Wellness Pope Avenue Wednesday 8 a.m. to 11 a.m. Satellite Clinic 1 st Floor Adult Hospital (South Entrance)

25 Questions?