Merrillville Community School Corporation Know Your Plan Options
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- Francine Wheeler
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1 Merrillville Community School Corporation Know Your Plan Options
2 Important to Know for 2018 There are NO PLAN CHANGES to benefits offered Employee Contribution rates remain the same as 2017 Employee Enrollment Options: Use Online Enrollment Form to make changes to your coverage, add coverage, terminate coverage Do nothing your insurance coverage for 2018 will remain the same as 2017 Decline coverage by using Online Enrollment Form to waive benefits Online Enrollment System: RDS
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14 Wellness Program Merrillville offers annual Wellness Screenings which are scheduled this year 10/31 11/3 onsite or now through 11/18 at Labcorp. A $300 single / $600 family annual wellness surcharge will be incurred for not participating. In addition, there is an annual $900 tobacco surcharge.
15 Questions To Consider For 2018 Benefits Do I have a Doctor? Do I take any medications? Have I heard of Teladoc? Do I have money today to cover healthcare? How will I pay for healthcare when I retire? Could I use a little more money? Based on your answer to these questions, you can save between $1,638 $4,058 if you review all your health plan options.
16 Single Coverage Annual Maximum In Network PPO HDHP Maximum Medical OOP Annual Employee Premium $1,500 + Rx Copays $3,000 $1,961 $1,523 Corp HSA Contribution $0 ($1,200) Total Annual Maximum $3,461+ Rx Copays (1) $3,323 (1) Rx OOP capped at $2,500
17 Family Coverage Annual Maximum In Network PPO HDHP Maximum Medical OOP Annual Employee Premium Corp HSA Contribution Total Annual Maximum $3,000 + Rx Copays $3,000 x 2 = $6,000 $5,720 $4,062 $0 ($2,400) $8,720 + Rx Copays (1) $7,662 (1) Rx OOP capped at $5,000
18 Single Coverage Benefit Plan Comparison In Network PPO HDHP Deductible $500 $3,000 Office Visit $20 Copay (1) 100% after Deduct. (1) Coinsurance 90% after Deduct. 100% after Deduct. Coinsurance Max $1,000 $0 Rx Copay $5 / $20 / $45 Copay 100% after Deduct. HSA $0 $1,200 Maximum OOP $1,500 +Rx Copays (2) $3,000 $1,200 HSA = $1,800 (1) Preventative Care covered 100%, Copay and Deductible Waived (2) Rx OOP capped at $2,500
19 Family Coverage Benefit Plan Comparison In Network PPO HDHP Deductible $500 x 2 = 1,000 $3,000 x 2 = $6,000 Office Visit $20 Copay (1) 100% after Deduct. (1) Coinsurance 90% after Deduct. 100% after Deduct. Coinsurance Max $1,000 per Member x 2 $0 = 2,000 Rx Copay $5 / $20 / $45 Copay 100% after Deduct. HSA $0 $2,400 Maximum OOP $3,000 + Rx Copays (2) $6,000 $2,400 HSA = $3,600 (1) Preventative Care covered 100%, Copay and Deductible Waived (2) Rx OOP capped at $5,000
20 Did You Know Your High Deductible Health Plan, or HDHP, comes with a Health Savings Account, or HSA MVSC contributes their $1,200 per year for single subscribers and $2,400 per year for family subscribers to your HSA on a quarterly basis (at the beginning of each quarter) You can contribute an additional $2,250 per year for single subscribers and an additional $4,500 for family subscribers Your HSA stays with you for life and is tax free when used for your healthcare. You can even use it as part of your retirement plan as you can access all of it, penalty free, after age 65
21 But Not in this case, it s in fact the opposite. Although the deductible is higher than the PPO, your monthly premium is significantly less. You are also receiving HSA money that has no expiration date. At the end of the day, you spend less money on the HDHP.
22 But What if I have a high claim cost and have to pay all at once? This is why you have your HSA. Worst case, medical providers always have payment plans to lighten the load. Remember, you re still paying significantly less on your premiums AND you are receiving your employer contribution at the beginning of each quarter.
23 But Your HSA stays with you for life. The contributions you or your employer make roll over year after year. People even use it as a retirement plan since you can access your money tax free and penalty free after age 65.
24 Which Plan Is Right For Me? Example 1 Single Coverage: Healthy Preventive Office Visit $ Generic Contraceptives (Preventive) $360 In Network PPO HDHP Premium ($1,961) ($1,523) Deductible $0 $0 Medical Copays $0 $0 Medical Coinsurance $0 $0 Rx Copays $0 $0 HSA Contribution N/A $1,200 TOTAL (1,961) (323)
25 Which Plan Is Right For Me? Example 2 Single Coverage: Type II Diabetes Medical Supplies $1,300 2 Office Visits $240 2 Generic/2 Brand Name Prescriptions/Month $7,944 Preventive Visit $150 In Network PPO HDHP Premium ($1,961) ($1,523) Deductible ($500) ($3,000) Medical Copays ($40) $0 Medical Coinsurance ($80) $0 Rx Copays ($1,200) $0 HSA Contribution N/A $1,200 TOTAL ($3,781) ($3,323)
26 Which Plan Is Right For Me? Example 3 Family Coverage: Expecting 1 st Child Hospital Charges (Mother) $9,000 Routine Obstetric Care (Mother) $2,100 ER Visit (Baby) $950 1 Generic Prescriptions/Month (Father) $360 1 Preventive Visit Each $450 In Network PPO HDHP Premium ($5,720) ($4,062) Deductible ($500) ($4,310) Medical Copays ($100) $0 Medical Coinsurance ($1,000) $0 Rx Copays ($60) $0 HSA Contribution N/A $2,400 TOTAL ($7,380) ($5,972)
27 Which Plan Is Right For Me? Example 4 Family Coverage: Accident Prone 12 Office Visits (4 Son, 8 Father) $1, Brand Prescriptions (Father) $3,600 4 Generic Prescriptions (Son) $360 MRI (Father) $1,500 X ray (Son) $460 In Network PPO HDHP Premium ($5,720) ($4,062) Deductible ($960) ($4,300) Medical Copays ($240) $0 Medical Coinsurance ($100) $0 Rx Copays ($560) $0 HSA Contribution N/A $2,400 TOTAL ($7,580) ($5,962)
28 Do you have a doctor? Yes No Are they part Are your visits of DMG? typically for preventive care or colds & flu? No No Do you take 2 or less prescriptions a month? Yes Yes No If you take 3 or more prescriptions a month you can see the true cost at More than 1,500 Single/3,000 Family Less than 1,500 Single/3,000 Family Consider Switching to the HDHP Stay Where You Are
29 Annual Benefit Enrollment Timeline Open Enrollment will be held from October 18, 2017 to November 17, 2017 for benefits effective January 1, 2018 to December 31, Recap of your enrollment options: Use Online Enrollment Form to make changes to your coverage, add coverage, terminate coverage Do nothing your insurance coverage for 2018 will remain the same as 2017 Decline coverage by using Online Enrollment Form to waive benefits The next opportunity to enroll, waive, or change benefits is not until the next Annual Benefit Enrollment period or within 31 days of an IRS qualifying life change event.
30 Annual Benefit Enrollment Assistance If you have any questions about plan benefits or enrollment, please contact your Employee Benefits Coordinator. Jamie Banashak (219) x 6018 jbanashak@mvsc.k12.in.us
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You can see the specialist you choose without permission from this plan.
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