Public Education Employees Health Insurance Plan PEEHIP BOARD MEETING 5/6/2015. Scheduled for May 28, 2015

Transcription

1 Public Education Employees Health Insurance Plan AASBO Conference May 2015 PEEHIP BOARD MEETING Scheduled for May 28, 2015 Members will be notified of any upcoming changes. PEEHIP Premium Rates October 1, 2014 September 30, 2015 Allocation per active employee $780 (increase from $714) Hospital medical premium for active employees: Single $ 15 Family $ 177 Optional plans Cancer, Indemnity, Vision, single dental $38 Family dental $45 Tobacco surcharge = $28 Pursuant to federal or state law, there will be premium increases for Cobra/Leave of Absence and Surviving Spouses rates shown on next slide. 1

2 PEEHIP Premium Rates October 1, 2014 September 30, 2015 COBRA and LOA Premiums Monthly Premium FY15 Increase Over FY14 Individual $ 409 $ 6 Family $ 1041 $ 44 Supplemental $ 156 $ 2 Surviving Spouse Premiums Monthly Premium FY15 Increase Over FY14 SS<65 $ 700 $ 21 SS<65, Depend<65 $ 934 $ 64 SS<65, Depend>65 $ 907 $ 68 SS>65 $ 354 $ 36 SS>65, Depend <65 $ 595 $ 79 SS>65, Depend >65 $ 568 $ 83 OPEN ENROLLMENT July 1 st August 31 st (paper) July 1 st September 10 th (online) Open Enrollment through Member Online Services (MOS). Link opens on July 1 st, PEEHIP will NOT automatically mail Open Enrollment Packets to members. Members can view and/or download the Open Enrollment Packet from the web page or can call PEEHIP and request a copy be mailed. Benefits of a Flexible Spending Plan Who benefits? Employees and School Systems How? Employees Use pretax dollars to get reimbursed for out of pocket health care expenses. School Systems Save on the matching FICA tax. 2

3 Flexible Spending Account Maximum Annual Contribution and Rollover Maximum annual amount for the Dependent Care account is $5,000 if single or married filing a joint return or $2,500 if married filing a separate return. Maximum annual amount for the Health Care account is $2,500. This amount will increase to $2,550 for the 2015 / 2016 plan year. Members are allowed to rollover up to $500 of unused funds remaining in their Health FSA at the end of the plan year to be used in the following plan year for eligible health care cost. The rollover amount does not affect the maximum contribution amount. Offering more than 1 Flexible Spending Account carrier? The Affordable Care Act (ACA) capped Health Flex Spending Accounts at $2,500. This amount will increase to $2,550 for the 2015 /2016 plan year. The ACA allows a maximum annual Rollover of $500. Some schools offer their own Health Flex plan in addition to PEEHIP s flex plan. Does your payroll software catch any excess contributions and add the excess back? IMPORTANT: If an employer permits salary reduction contributions to exceed this limit, the FSA will not be considered a qualified benefit, and the cafeteria plan could lose its tax advantage status. This will impact the Flex plan as well as the Premium Conversion benefit. The Benefits of Having a Wellness Program The Team Up for Health Wellness Program is designed to reverse the risk and disease trends that our membership is currently facing by offering health management solutions to help improve health outcomes and save lives Because of the new wellness program, PEEHIP members are receiving a new wellness benefit and did not experience: Monthly premium increases Reduction in benefits Increases in copays and deductibles 3

4 Who is Required to Participate? Required if enrolled in PEEHIP BCBS hospital/medical plan (group #14000) and: Active members and their covered spouses Non Medicare eligible retirees Covered non Medicare eligible spouses of retirees COBRA, Leave of Absence, Surviving Spouses NOT required to participate: Medicare eligible retirees Medicare eligible spouses on retired contracts Children Members who are only enrolled in VIVA, Optionals, Supplemental Must be enrolled in group #14000 hospital medical plan to be required What is Participation? PEEHIP Wellness is a Participatory Program, which means members and eligible spouses must only participate, not meet any specific health standard For example, a member will still get the financial incentive if they have an abnormal body mass index (BMI) Participation is easy and will help ensure members enjoy results of living their healthiest and most capable life Earn a Waiver of the Monthly Wellness Premium $50 monthly wellness premium applied separately to subscribers and spouses effective 10/1/2015 for those who do not participate or complete their annual wellness program requirements by 07/15/2015 PEEHIP does not want anyone to incur the additional $50 monthly wellness premium Wellness premium can be removed prospectively after requirements completed 4

5 Required by all eligible members by 7/15/15 1. Complete a Wellness Screening To be completed between 8/1/ /15/ Complete the Health Questionnaire Health Questionnaire (HQ) available online at Telephonic HQ also available at Additional requirements for those who are notified they are a candidate 3. Participate in Wellness Coaching ActiveHealth Health Coach works to reduce health risk and coach members to manage weight, get moving, manage stress, eat healthier & more 4. Participate in Disease Management ActiveHealth Nurse Coach helps with self examination, adherence to medication, knowing when to seek treatment, etc The 5 Chronic disease states identified for wellness coaching and disease management are asthma, diabetes, coronary artery disease, congestive heart failure, COPD ActiveHealth will identify candidates based on 5 disease states listed above as well as tobacco use How to Complete Wellness or Disease Management Coaching Online: Log in to to earn 100 heartbeat units (which equals 1 heartbeat goal) of online coaching to complete this requirement. Telephonic: ActiveHealth nurses and coaches can be reached at from 8:00am 8:00pm, Monday Friday; 8:00am 1:00pm, Saturdays if you do not have access to the Internet. On site health coaching clinics: PEEHIP now offers group health coaching sessions as an option for members to complete the coaching requirement. Three ActiveHealth wellness coaches are available to travel the state and lead on site group coaching classes for any PEEHIP member, covered spouse, or retiree that would like to attend. 5

6 Retiree Employment Verification All members who retired on or after 10/1/2005 will soon be required to verify Retiree Employment Information yearly Under PEEHIP Law, if a member retired on or after October 1, 2005, and is employed by another employer that provides at least 50% of the cost of single health insurance coverage, the retiree cannot be insured on the PEEHIP hospital medical plan. ACA Updates on Employer Mandates The Individual Share Responsibility provisions of the Affordable Care Act (ACA) requires all individuals to maintain minimum essential coverage for each month of the calendar year, or pay a penalty when filing his or her federal income tax return if he or she is not eligible for an exemption. This requirement went into effect on January 1, 2014, with reporting of minimum essential coverage on federal income tax returns occurring for the first time in early ACA Updates on Employer Mandates With the ACA s Employer Mandate, the ACA added Section 6056 to the Internal Revenue Code, which requires an applicable large employer to annually file reports with the IRS and provide a statement to its full time employees detailing the health insurance coverage it provided to employees. This reporting is completed through the use of Form 1094 and It was originally intended to begin in 2015 for the 2014 calendar year. Later, however, transitional relief delayed the effect of this mandatory reporting, making reporting for 2014 optional. Accordingly, PEEHIP will provide the required 1095 tax form to all participants to show proof of insurance coverage in

7 PEEHIP REVENUE Keeping the Employer Portal Up to Date Use correct dates and correct SSN Hire, FMLA, LOA and Termination Dates are very important FMLA earns allocations and LOA burns allocations PEEHIP cannot enroll new employees until the employee is entered in the Employer Portal. Please enter them as soon as they are hired. Please do not enter dates beyond a 6 month window of time. Our system needs to send certain notifications that will fail if the date is too far out in time. Don t hire, terminate and rehire on the same day Terminating or Retiring Employees Update the ER Portal on the date the employee retires. Do not wait until the allocations are burned. Remember to enter the 16 th of the month or later for the termination date if a member should earn the allocation for that month. Employer must pay the allocations that are earned under the 3 1 rule, and retiree should stay on the invoice until all allocations are burned. Do not change the class to zero (0). Only change class code if member is changing to/from full time to part time 7

8 PEEHIP Revenue Contacts A B: Petrice Robinson C E: Summer Wert F J: Laquanda James L M: Dawn Wood N R: Katrina Henry S T: Matthew Olson V W: Shawantha Thomas Phone: READ the PEEHIP ADVISOR Important information is always included in the PEEHIP Advisor. The PEEHIP Advisor is a part of the RSA Advisor. PEEHIP Contacts PEEHIP: Phone # Fax# PEEHIPINFO@rsa al.gov ACTIVEHEALTH: ADPH: BCBS: MEDIMPACT: SOUTHLAND: VIVA:

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