2017 What s New Guide

Transcription

1 2017 What s New Guide

2 2 Click on a link in the sidebar to get started. At XL Catlin, you partner with us to serve our clients, so we partner with you to provide valuable health and welfare benefits. Each year we evaluate our plans to ensure they continue to meet your needs today and in the future. To make sure we continue moving forward, we are making changes to our benefits. These changes help us remain competitive while providing cost-effective benefits for you. For 2017, you ll see changes to our medical coverage, and you ll also have access to new features, like Cigna 90 Now, and an enhanced wellness program, Staying Well via Cigna s MotivateMe platform. During Annual Enrollment, we encourage you to review your benefits to make sure you receive the coverage you need in You must make your benefit elections between November 1 and 15, If you do not elect or change your coverage during the enrollment period, you will receive the same coverage that you have in 2016 with the exception of Flexible Spending Accounts (FSAs), which must be re-elected each year. In addition, if you do not make a change, your 2017 medical plan election will reflect your tobacco and working spouse/domestic partner status from your 2016 enrollment, if applicable. Please note: You will also receive new Cigna medical and prescription ID cards, even if you do not change your coverage. Find out more about what s new for 2017 in the following pages, and consider the benefits that will be available in Remember: It s your coverage. Make it count. ACTION REQUIRED FOR ALLIED COLLEAGUES You must make your benefit elections between November 1 and November 15, If you do not elect your coverage during the enrollment period, you will not have benefits for If you want to print this guide or a specific section, simply click on the button found at the top right of each page. You can print the complete guide or enter a page range.

3 3 How the OAP HSA Plans Work A Closer Look at the HSA We re making adjustments to all three medical plans OAP, OAP HSA 1 and OAP HSA 2 for 2017, as well as what you pay for your coverage. The good news? We re making minimal changes to the HSA plans, so you ll continue to have cost-effective, comprehensive coverage choices. To understand each plan and how they are different, review the plan comparison chart here. Refer to the chart below to review medical plan details for Review the 2017 rates here. Remember: All three plans provide access to the Cigna Open Access Plus (OAP) network. Not sure which medical plan is right for you? See how colleagues like you decide which plan is right for them. Deductible (Single/Family) Out-of-Pocket Maximum (Single/Family) PCP Office Visits Specialist Office Visits OAP OAP HSA 1 OAP HSA 2 In-Network Out-of-Network In-Network Out-of-Network In-Network Out-of-Network $750/$1,500 $2,500/$5,000 $1,500/$3,000 $3,000/$6,000 $2,500/$5,000 $4,000/$8,000 $3,000/$6,000 $6,000/$12,000 $4,000/$8,000 $6,000/$12,000 $5,000/$10,000 $8,000/$16,000 $25 copay $50 copay 40% after 40% after Emergency Room $150 copay $150 copay 40% after 40% after In-Network Preventive Care* Covered at 100% XL Catlin-Funded Annual HSA Contribution N/A $625/$1,250 $500/$1,000 * Preventive care services include, but are not limited to well baby, well child, adult preventive care, well woman exams, mammograms, PSA and pap smears. 40% after 40% after Working Spouse/Domestic Partner Premium and Tobacco User Surcharge When you enroll, you will see information about the working spouse/domestic partner premium and the tobacco user surcharge. For more information, visit myxlcatlinbenefits.com. Go to My Health > Eligibility and Enrollment.

4 4 How the OAP HSA Plans Work How the OAP HSA Plans Work A Closer Look at the HSA OAP Network and Plan Features The OAP HSA plans share many features of the OAP plan: A broad network of doctors and hospitals in the Cigna Open Access Plus (OAP) network. Flexibility of in- and out-ofnetwork coverage, with higher benefits for in-network coverage. Preventive care covered at 100% from in-network providers. An out-of-pocket maximum to protect you from the expense of catastrophic injury or illness. + Health Savings Account (HSA) The HSA allows you to pay for eligible healthcare expenses, including your, with tax-free dollars and XL Catlin contributes funds to your HSA each year. With the HSA, you have the freedom to use your account balance now or in the future there isn t a use it or lose it rule and the funds roll over year to year. And, you can take your HSA with you if you ever retire or leave XL Catlin. = OAP HSA Plans With the OAP HSA 1 and OAP HSA 2 plans, you have the opportunity to open a taxadvantaged HSA to help offset out-of-pocket costs. All eligible preventive care obtained at an in-network provider is covered at 100% without having to satisfy the first. You pay less through payroll contributions and more if or when you use the plan. Ultimately, you have more control over your healthcare dollars. Pay Now or Pay Later Another way to think about the differences among the plans is when you want to pay for care: would you prefer to pay more out of your paycheck and less at the point of care, or less out of your paycheck and more at the point of care? Through Employee Contributions At the Point of Care OAP OAP HSA 1 OAP HSA 2

5 5 A Closer Look at the HSA How the OAP HSA Plans Work A Closer Look at the HSA The Health Savings Account (HSA) allows you to use pre-tax dollars for care for your current and future healthcare expenses. It s only available to participants in the OAP HSA 1 and OAP HSA 2 plans. How the HSA Works Build It Enroll in the OAP HSA 1 or OAP HSA 2 and make pretax contributions to your account. XL Catlin will also make contributions to your account (OAP HSA 1 Plan: $625 single/$1,250 family; OAP HSA 2 Plan: $500 single/$1,000 family). Use It Use the HSA funds to pay for covered healthcare expenses for yourself and your dependents. You may use your HSA debit card to pay for care on the spot no need to file a claim for reimbursement! You may also use it like an ATM card to reimburse yourself for eligible out-of-pocket expenses.* Grow It Unused money in your account will roll over to the next year. Your account balance will earn interest tax-free. Once you reach a $2,000 balance in your HSA, you can choose from the account s options for investing your balance via HSA Bank. Keep It You own the money in your HSA. You can even take the account with you if you retire or leave XL Catlin. *You may only submit out-of-pocket expenses for tax qualified dependents. Triple Tax-Advantage of the HSA When you contribute to and use an HSA, you gain the following advantages: Money goes into your account tax-free. You contribute pre-tax dollars, which helps reduce your taxable income. Money grows tax-free through interest and investment earnings. Your account balance earns interest tax-free. And, once you have a minimum balance ($2,000), you can choose from a variety of investment funds available via HSA Bank to maximize your balance. Money stays tax-free when you spend it on eligible healthcare expenses. When you withdraw funds, it is tax-free, as long as you use the funds for eligible medical, dental, and vision expenses.

6 6 Cigna 90 Now Want the convenience of prescription drug home delivery and the speed and personal touch of your local pharmacy? Cigna 90 Now gives you just that. This new feature allows you to fill a 90-day supply of maintenance medicine at participating pharmacies in the 90- day network at a location near you. Participating pharmacies in the 90-day network include CVS, Walmart, Access Health and others. With Cigna 90 Now, you ll be able to: Pick up your medications at a time that is convenient for you. Enjoy same-day prescription availability. Talk with a pharmacist face-to-face. You can visit or the mycigna Mobile App and click Get Drug Costs Now to view estimated costs for maintenance medications based on your pharmacy plan, see if there are lower cost alternatives and view prices at 90-day retail pharmacies. Enhanced Telehealth Program from Cigna Starting in 2017, Cigna will provide access to two telehealth services as part of your medical plan: AmWell and MDLIVE. Cigna Telehealth Connection lets you get the care you need, including most prescriptions for a wide range of minor conditions. Now you can connect with a board-certified doctor via secure video chat or phone, without leaving your home or office. When, where and how it works best for you! For more information, visit AmWellforCigna.com (effective January 1, 2017) or call , or visit MDLIVE.com/XLAmerica or call AmWell and MDLIVE are only available for medical visits. For covered services related to mental health and substance abuse, you will also have access to the Cigna Behavioral Health network of providers. New Out-of-Network Reimbursement Starting in January 2017, when you visit a provider or facility that is not in the Cigna OAP network, your reimbursement will be based on 200% of a fee schedule developed by Cigna that is based on a methodology similar to one used by Medicare to determine the allowable fee for the same or similar service in a geographic area. Using a Medicare-based fee schedule, rather than a percentile of reasonable and customary charges, provides more consistency in how out-of-network claims are reimbursed. Stay In-Network and Save You generally pay lower costs for care obtained from an in-network provider. This means that you use a doctor or facility that s in the OAP network, regardless of which medical plan you choose. When you see an out-of-network provider, you ll pay more for care. Before you visit your doctor, make sure he or she is in the OAP network to receive the maximum benefit.

7 7 Get ready to live your best life in 2017 and earn up to $300 while you re at it. We re partnering with Cigna to offer you a new and improved Staying Well program. This new wellness program gives you and your covered spouse/domestic partner the information and resources to help you become healthier and more informed healthcare consumers and rewards you for doing so! Note: The maximum annual reward you can receive is $150 for completing healthy actions. This reward is in addition to the $150 for completing your biometrics and health assessment by the March 31, 2017 deadline. You can choose different actions related to your health, chronic conditions, well-being and money management that can add up to the $150. Wellness Incentive Eligibility You are eligible for up to $300 in wellness incentives, and, if your spouse/domestic partner is covered by an XL Catlin medical plan, he or she is, too! In order to get started, you and your covered spouse/domestic partner must complete the health assessment and biometric screening to qualify for any other healthy action rewards, which you'll receive in the form of debit and/or gift cards. To track your progress, visit the Cigna website at Click here to see examples of how you can earn incentives ranging from $25 to $100 for making healthy choices in every aspect of your life.

8 8 Activities and Incentives Maintaining and improving every aspect of your health is an important part of staying well. See examples of the activities you can complete in order to achieve your health, wellbeing and financial goals, and earn rewards. Goal Reward Complete health assessment and biometric screening by March 31, 2017 $150 1 Complete healthy actions by deadline 2 Up to $ You can earn this incentive even if you have waived medical coverage with XL Catlin. However, your spouse/domestic partner can only participate if covered under the XL Catlin medical plan. 2 You must complete the health assessment and biometrics to qualify for healthy action rewards. Note: Examples of healthy actions include annual preventive exams, cancer screenings, flu shots, and use of telehealth and EAP/worklife benefits. For a full list of activities, visit starting January 1, Getting Started Is Easy Starting January 1, 2017, visit and select Incentive Awards Program to: Find detailed instructions on how to get started. View a list of eligible goals and matching rewards. Check and track your completed goals and earned rewards. For more information or help setting up your account, visit mycigna.com or call customer service at

9 9 Meet Jim Meet Taylor Meet Henry Choose Well for 2017: Get to Know a Choosing a medical plan is easier than you may think, especially when you have the information you need to make an informed decision. Take Jim, Taylor and Henry for example. Each individual is weighing the same options you are. Jim Healthy and fit, with minimal medical needs Taylor Chronic medical issues keep her and her daughter at the doctors Henry Frequently uses healthcare for his family See how Jim, Taylor and Henry choose their medical plan for 2017.

10 10 Meet Jim Meet Taylor Meet Henry Choose Well for 2017: Get to Know a Meet Jim Jim is a healthy, single 27 year old who earns an annual base salary of $125,000. He s been healthy for the past few years and doesn t anticipate needing frequent medical services in Even though he doesn t think he ll need frequent care, he still wants comprehensive coverage and to pay minimal premiums per paycheck contribution. Service Jim s Healthcare Costs Member Fee* (received in order listed) OAP OAP HSA 1 OAP HSA 2 Jim 1 Preventive Care Exam $150 $0 $0 $0 Jim 1 Dermatologist Visit $200 $50 ($50 copay/visit) $200 (toward ) $200 (toward ) Jim 1 PCP Visit $150 $25 ($25 copay/visit) $150 (toward ) $150 (toward ) Jim 1 Generic Prescription Drug $15 $10 $15 (toward ) $15 (toward ) (Retail) Total Healthcare Costs: $85 $365 $365 XL Catlin s Annual HSAContribution: N/A $625 $500 Jim s Total Out-of-Pocket Costs For Care $85 $0 $0 Jim s Remaining HSA Balance N/A $260 $135 Jim s Annual Payroll Contributions: $1,752 $936 $648 Jim s Total Annual Healthcare Costs: $1,837 $936 $648 *Fees based on allowable in-network charges. This plan is most cost-effective for Jim

11 11 Meet Jim Meet Taylor Meet Henry Choose Well for 2017: Get to Know a Meet Taylor Taylor is 35 years old and earns an annual base salary of $70,000. Taylor and her daughter, Mallory, have chronic health conditions that require significant medical attention, including many doctor visits and maintenance medications. Taylor wants to ensure she and her daughter receive the care they need while paying minimal out-of-pocket costs throughout the year. Member Service Taylor s Healthcare Costs Fee* (received in order listed) OAP OAP HSA 1 OAP HSA 2 Taylor 1 Preventive Care Exam $150 $0 $0 $0 Mallory 1 Well Child Exam $150 $0 $0 $0 Taylor 2 PCP Visits ($150 Each) $300 $50 ($25 copay/visit) $300 (toward family ) Taylor 2 Podiatrist Visits ($200 Each) $400 $100 ($50 copay/visit) $400 (toward family ) Taylor Taylor Taylor 3 Endocrinologist Visits ($200 Each) 2 Generic Retail Prescription Drugs ($25 Each, 30-Day Supply) 4 Generic Mail Order Prescription Drugs ($25 Each, 90 Day Supply) $600 $150 ($50 copay/visit) $600 (toward family ) $300 (toward family ) $400 (toward family ) $600 (toward family ) $50 $20 $50 (toward family ) $50 (toward family ) $100 $80 $100 (toward family ) Mallory Heart Surgery $130,000 $3,000 ($750 to meet Mallory + 20% coinsurance to meet her $3,000 out-of-pocket max) $4,000 ($1,550 to meet family + 20% coinsurance to meet her out-of-pocket max) $100 (toward family ) $5,000 ($3,550 to meet family + 20% coinsurance to meet her out-of-pocket max) Mallory 3 Cardiologist Visits ($300 Each) $900 $0 $0 $0 Mallory 4 Non-Preferred Brand Mail Order Prescription Drugs ($360 Each, 90 Day Supply) $1,440 $ ($75 to meet the Rx +30% coinsurance/ prescription drug) $0 $0 Total Healthcare Costs: $3, $5,450 $6,450 XL Catlin s Annual HSA Contribution: N/A $1,250 $1,000 Taylor s Total Out-of-Pocket Costs For Care: $3, $4,200 $5,450 Taylor s Remaining Hsa Balance: N/A $0 $0 Taylor s Annual Payroll Contributions: $3,264 $2,016 $1,200 Taylor s Total Annual Healthcare Costs: $7, $6,216 $6,650 *Fees based on allowable in-network charges. Note: This example has been revised. This plan is most cost-effective for Taylor

12 12 Meet Jim Meet Taylor Meet Henry Henry is 45 years old and married to his wife Sarah. Together they have two children, Maryellen and Jane, and are expecting their third child. Henry earns an annual base salary of $200,000. Henry and Sarah are frequent users of healthcare and are on a tight budget this year. Member Service (received in order listed) Fee Henry s Healthcare Costs OAP OAP HSA 1 OAP HSA 2 Henry Preventive Care Exam $150 $0 $0 $0 Sarah Well Woman Exam $150 $0 $0 $0 Maryellen & Jane 2 Well Child Exams ($150 Each) $300 $0 $0 $0 Maryellen & Jane Henry 5 PCP Visits ($100 Each, 2 Visits For Maryellen, 3 For Jane) 5 Generic Retail Prescription Drugs ($20 Each,30 Day Supply) Choose Well for 2017: Get to Know a Meet Henry $500 $125 ($25 copay/visit) $500 (toward family ) $100 $50 $100 (toward family ) Jane Emergency Room Visit $1,500 $150 $1,500 (toward family Jane 2 Orthopedic Visits ($200 Each) $400 $100 ($50 copay/visit) $400 (toward family ) Sarah 10 Prenatal Visits ($125 Each) $1,250 $875 ($50 copay for 1 st visit plus $750 toward her +20% coinsurance) $650 ($500 to meet family + 20% coinsurance) $500 (toward family ) $100 (toward family ) $1,500 (toward family ) $400 (toward family ) $1,250 (toward family ) Sarah Labor and Delivery $4,000 $800 (20% coinsurance) $800 (20% coinsurance) $1,800 ($1,250 to meet family + 20% coinsurance) Total Healthcare Costs: $2,100 $3,950 $5,550 XL Catlin s Annual HSA Contribution: N/A $1,250 $1,000 Henry s Total Out-of-Pocket Costs For Care: $2,100 $2,700 $4,550 Henry s Remaining HSA Balance: N/A $0 $0 Henry s Annual Payroll Contributions: $7,584 $4,752 $3,096 Henry s Total Annual Healthcare Costs $9,684 $7,452 $7,646 This plan is most cost-effective for Henry

13 13 To make changes to your coverage for 2017, you must enroll from November 1 to November 15, If you do not elect or change your coverage during the enrollment period, your 2016 elections will carry over into 2017 with the exception of FSAs, which must be re-elected each year. In addition, if you do not make a change, your 2017 medical plan election will reflect your tobacco and working spouse/domestic partner status from your 2016 enrollment, if applicable. If you are an Allied colleague, you must make your benefit elections between November 1 and November 15, If you do not elect your coverage during the enrollment period, you will not have benefits for How to Enroll You will elect your benefits through myhr. To access myhr, visit XL Catlin s intranet, The Pen. See the Benefits Enrollment for Colleagues reference guide to assist you in navigating the enrollment system. When you enroll, you have the opportunity to: Enroll in or waive your medical, dental and vision plan benefits for Enroll in a Health Care FSA, Limited Purpose FSA and/or Dependent Day Care FSA, and an HSA, if applicable. Elect supplemental life insurance coverage, including supplemental employee life, supplemental AD&D, and dependent life insurance, and update beneficiary designations. Elect tax-choice or basic long-term disability coverage. Questions? For more information about your benefits, visit myxlcatlinbenefits.com. Remember to Enroll in an FSA or Supplemental Life Insurance If you would like to contribute to an FSA in 2017, be certain to elect a contribution amount during the enrollment process. You must make an election during Annual Enrollment in order to contribute to an FSA in Keep in mind you may carry over up to $500 of your remaining 2016 Health Care or Limited Purpose FSA balance into In addition, if you re considering enrolling in supplemental life insurance for 2017, you must enroll during Annual Enrollment, as there won t be another enrollment period until next year s Annual Enrollment. You will only be able to make a change to your benefits if you experience a qualified life event in 2017.