Fordham University Benefits Open Enrollment Overview for Local 153

Transcription

1 Fordham University 2018 Benefits Open Enrollment Overview for Local 153

2 What We ll Cover Medical Plan Options A Closer Look at the Enhanced Standard Option A Closer Look at the Health Investment Option A Closer Look at the Accounts - HRA, HSA, Healthcare FSA, Limited Purpose FSA Dental Plan Option Additional Benefits 2018 Open Enrollment Timeline Resources Purpose of Today's Presentation Explain what's changing about your Fordham medical plan for 2018 and why. Help you more fully understand your benefit options for 2018, so you can make an informed choice during enrollment Answer your questions 2

3 Medical Plan Options

4 Medical Plan Options For 2018, Fordham will offer one plan through UnitedHealthcare with two options: The Enhanced Standard Option The Health Investment Option (formerly known as the Health Savings Account Option) Prescription drugs coverage is automatic under both options Both options are offered through UHC Choice Plus provider network Your cost will always be lower when you stay in-network for care UHC: A Good Network for Fordham There is no change to the network we are using, which means you keep your in-network provider. In fact, 93% of providers who have recently cared for Fordham members are in the UHC Choice Plus network. 4

5 Medical Plan Options 2018 Options Feature Enhanced Standard Option Health Investment Option Coverage Type Traditional Preferred Provider Organization (PPO) focused on current year expenses Combines traditional medical coverage with a Health Savings Account you can use to pay long-term medical expenses Provider Choice Both options provide in- and out-of-network benefits Preventive Care Both options pay 100% for in-network preventive care Covered Services Same covered services plus certain Enhanced Option benefits Pairs with an Account Health Reimbursement Account (HRA) only Fordham contributes. Limited rollovers; primarily designed for current year costs Same covered services Health Savings Account (HSA) you can and Fordham will contribute. Unlimited rollovers and plan growth; designed for both current year and long-term costs 5

6 A Closer Look at the Enhanced Standard Option

7 The Enhanced Standard Option Plan Feature. In-network Enhanced Standard Option Out-of-network Preventive care Covered in full You pay 20% after deductible has been met Deductible $250 employee-only / $300 employee-only / $500 family $600 family Office visits Primary Care: $25 copay* Specialist/Urgent Care: $50 copay* Major diagnostics You pay 20% after deductible has been met (e.g., CT, PET, MRI): $250 copay* Diagnostic and lab Minor diagnostics (e.g., X-rays): You pay $0 services Lab services: You pay 5% after deductible has You pay 20% after deductible has been met been met Emergency room $100 Copay (Waived if Admitted) $100 Copay (Waived if Admitted) Outpatient surgery You pay 5% after deductible has been met You pay 20% after deductible has been met Hospital inpatient $250 copay* You pay 20% after deductible has been met Most other covered services You pay 5% after deductible has been met You pay 20% after deductible has been met Out-of-pocket maximum $2,500 employee-only / $2,500 employee-only / $5,000 family $5,000 family Fordham s HRA contributions $400 for employee-only coverage and $800 for family coverage * Copays do not accumulate towards the in-network deductible, but they do count towards your in-network out-of-pocket maximum 7

8 The Enhanced Standard Option Your prescription drug coverage is offered through UHC, just like your medical coverage. Here s how prescription coverage works: Prescription Drug Category Tier 1 (lowest-cost option, typically generic drugs) Tier 2 (mid-range cost option, mostly preferred brandname drugs) Tier 3 (highest-cost option, typically non-preferred brand-name drugs) Your Prescription Copays Retail (31-day Max) Mail Order (90-day Max) $10 $20 $25 $50 $50 $100 8

9 The Enhanced Standard Option You may wish to consider the Enhanced Standard Option if: You and your family have high medical expenses The Fordham-funded HRA is adequate for current year costs You want to keep out-ofpocket costs low and pay more in paycheck deductions You are interested in coverage enhancements, including unlimited rehabilitative services 9

10 Understanding the HRA The Enhanced Standard Option works with the Health Reimbursement Account (HRA), which is set up by Fordham. It reimburses you for out-of-pocket expenses such as your plan s deductible, copays, coinsurance, and dental and vision care. Features Fordham contributions only. Tax advantages. Rollover of unused HRA balance (limited). Account access if you leave (limited). Contributions Fordham will contribute the following amounts to your HRA for the 2018 calendar year. Note: Employee contributions are not permitted to the HRA. However, employees can open a Health Care FSA to make pre-tax contributions for eligible health care expenses. HRA Coverage Level Fordham s Contribution Employee-only $400 Family $800 10

11 A Closer Look at the Health Investment Option

12 The Health Investment Option Plan Feature In-network Health Investment Option Out-of-network Preventive care Covered in full You pay 40% after deductible has been met Deductible $1,500 employee-only / $3,000 employee-only / $3,000 family $6,000 family Office visits Primary care, specialist You pay 20% after deductible has been met You pay 40% after deductible has been met and urgent care Diagnostic and lab services You pay 20% after deductible has been met You pay 40% after deductible has been met Emergency room You pay 20% after deductible has been met You pay 20% after deductible has been met Outpatient surgery You pay 20% after deductible has been met You pay 40% after deductible has been met Hospital inpatient You pay 20% after deductible has been met You pay 40% after deductible has been met All other covered services You pay 20% after deductible has been met You pay 40% after deductible has been met Out-of-pocket maximum $3,000 employee-only / $6,000 employee-only / $6,000 family $12,000 family Fordham s HSA contributions $750 for employee-only coverage and $1,500 for family coverage 12

13 The Health Investment Option Your prescription drug coverage is offered through UHC, just like your medical coverage. Here s how prescription coverage works Prescription Drug Category Tier 1 (lowest-cost option, typically generic drugs) Tier 2 (mid-range cost option, mostly preferred brandname drugs) Tier 3 (highest-cost option, typically non-preferred brand-name drugs) Your Prescription Copays (Copays apply after deductible is met) Retail (31-day Max) Mail Order (90-day Max) $10 $25 $35 $87.50 $60 $150 13

14 The Health Investment Option You may wish to consider the Health Investment Option if: You and your family have low medical expenses You re interested in saving for eligible long-term expenses with the HSA You are looking for more opportunities to save on taxes You want to avoid paying for more coverage than you need 14

15 Understanding the HSA With the Health Investment Option, you ll have access to a tax-advantaged HSA. Features Fordham automatically contributes. You can contribute, too, up to the IRS maximum. There is no use it or lose it rule. Triple tax advantages. 0 Another Way to Save for Retirement When you open your HSA, you can save money tax-free and receive tax-free contributions from Fordham to help you pay for eligible health care expenses. You can use your balance today to pay for eligible health care expenses or you can use your HSA to help you save for your retirement. 15

16 Understanding the HSA Health Savings Account Coverage Level 2018 Health Savings Account Contribution Limits Fordham s Contribution Your Maximum Contribution Under Age 55 Employee only $3,450 $750 $2,700 Family $6,900 $1,500 $5,400 Age 55 Until Enrolled in Medicare* Employee only $4,450 $750 $3,700 Family $7,900 $1,500 $6,400 *Employees age 65+ who are enrolled in Medicare will not be able to make contributions to your HSA nor receive them from Fordham. Fordham contributions to the Health Savings Account will increase so that you can use them to offset expenses under the Health Investment Option $750 for employee-only and $1,500 for family coverage. 16

17 Employee Example: The HSA in Action Joe Married with family coverage Managing chronic conditions Is 55 years old, planning for retirement and making annual catch-up contributions Uses providers in the UHC Choice Plus network After age 65, HSA funds can be used: For non-medical expenses, subject to regular income tax, but without penalty Tax-free on qualified medical expenses, including Medicare premiums Year 1 Year 2 Year 3 HSA rollover balance N/A $7,900 $15,800 Fordham s contribution* $1,500 $1,500 $1,500 Joe s contributions** $6,400 $6,400 $6,400 Joe s non-preventive expenses (in-network preventive care covered at 100%) $3,100 $3,400 $6,000 HSA reimbursements $0 $0 $6,000 HSA balance at year-end*** $7,900 $15,800 $17,700 *Assumes Fordham s HSA contribution amounts remain the same for 2019 and 2020 **Assumes 2018 IRS contribution maximum for family coverage ($6,900 plus $1,000 in catch-up contributions for those 55 and older) continues unchanged in future years ***Does not consider possible investment gains or losses Years 1 and 2: Joe chooses to save aggressively for retirement and not use his HSA for his annual out-of-pocket costs Year 3: Joe is protected by the out-of-pocket maximum; he also chooses to use HSA funds to pay this out-of-pocket amount, $6,000 17

18 A Closer Look at the Accounts

19 A Closer Look at the Accounts Health Reimbursement Account (HRA) Health Savings Account (HSA) Applies if you enroll in Enhanced Standard Option Health Investment Option Purpose Current year health care expenses only Current year and long-term health care expenses Annual Fordham contribution Employee-only: $400 Family: $800 Can you contribute tax-free dollars? Covers what eligible expenses? No employee contributions permitted Qualified expenses, like deductible, coinsurance and copays. For a complete list of eligible expenses, visit irs.gov and see Publication 969. Employee-only: $750 Family: $1,500 Yes, up to IRS limits Qualified medical, dental, and vision expenses, such as prescription drugs, eye exams and more. For a complete list of eligible expenses, visit irs.gov and see Publication 502. Rollover limit for unused dollars at year end? Take funds with you when you retire or leave Fordham? Can you contribute to a Health Care Flexible Spending Account? Up to December 31, 2020 No (but unused funds may be used for up to one year provided termination of employment occurs before December 31, 2020) Yes No limit Yes Yes, only through a Limited Purpose FSA which can be used only with an HSA 19

20 Discovery Benefits HRA, HSA and FSA Administrator Discovery Benefits will be the new Administrator for Health Reimbursement Accounts (HRAs), Health Savings Accounts (HSAs) and Flexible Spending Accounts in 2018 Health Care FSA and Limited Purpose FSA Health Care FSA pays for unreimbursed medical, dental, vision expenses; $2,600 maximum contribution (Pairs with the Enhanced Standard Option) Limited Purpose FSA pays for unreimbursed dental and vision expenses only; $2,600 maximum contribution (Pairs with the Health Investment Option) Account contributions reduce your taxable income Use it or lose it feature applies Single debit card for FSA and HRA or HSA makes it easy to pay expenses Dependent Care FSA Dependent Care FSA pays for care of dependent(s) while you work; $5,000 maximum contribution 20

21 Discovery Benefits Tools & Resources Free and Secure Check Balances File Claims View Transactions Image Capture Text Alerts (24/7 IVR) 7:00 am 10:00 pm Monday Friday Use our resources at FSA Guide Eligible Expenses 21

22 Make the Most of Your Medical Plan Save with your FSA if enrolling in the Enhanced Standard Option: If you think your out-of-pocket expenses will exceed the amount Fordham funds in your HRA, or if you want to pay for eligible health care expenses tax-free, contribute to a Health Care FSA. Save with your HSA if enrolling in the Health Investment Option: Fordham funds your HSA and you can, too. Use it toward your deductible today or save it for tomorrow s unexpected health care costs or for expenses in retirement. Save with your LPFSA if enrolling in the Health Investment Option: The Limited Purpose FSA provides another way to pay for eligible dental and vision expenses with pre-tax dollars and helps you save your HSA balance for current or future medical expenses 22

23 Dental Plan Option

24 Dental Plan Option One option available through Cigna at No Cost to You Dental Health Management Organization (DHMO) In-network benefits only Find a Cigna dental provider at Cigna.com or call (800) Plan Feature DHMO Provision Deductible Preventive diagnostic Basic restorative care No deductible No cost to you for preventive/ diagnostic care, or basic fillings; cost sharing for other services based on Cigna schedule Major restorative care Orthodontia Calendar year maximum benefit No maximum benefit 24

25 Additional Benefits

26 Life insurance Offered through First Reliance Standard Coverage at $10,000 Paid by Fordham 26

27 Value-added plans Care 24 Employee Assistance Program (EAP) Counseling, resources and referrals, access to support for family issues, relationship management, workplace challenges, stress management Critical illness Waiver of life insurance premiums and lump sum benefit to help with unexpected costs in event of grave illness or injury Identity theft protection Assistance with all aspects of security theft Restoration of credit rating On Call 24-hour travel assistance Support for travel plans and in travel emergencies Especially valuable for overseas travel information about immunizations, passports, currency, foreign consulates; assistance with medical emergencies, lost passports or lost luggage 27

28 Value-added plans Health Advocate Health professionals to help you navigate healthcare and insurancerelated issues Call the single, toll-free number; you ll be assigned a Personal Health Advocate (PHA) who understands your Fordham benefits and interacts with providers and health plans on the your behalf Your PHA can help you: Find qualified providers Expedite appointments Get health cost estimates Resolve insurance claims Negotiate billing Understand your benefits Work with insurance companies on approvals Transfer medical records Get unbiased information on complex conditions Research treatment options or find a best in class facility Prepare for a doctor appointment Secure a second opinion Find or manage elder care Understand test results Find community resources 28

29 2018 Open Enrollment

30 2018 Open Enrollment Go to fordham.edu/2018benefits to access the following resources: Health Investment Option User Guide Enhanced Standard Option User Guide Medical Plan Cost Estimator Videos Enroll between October 30 and November 17. To access the enrollment website, go to my.fordham.edu, select the Human Resources tab and click on "Open Enrollment" 30

31 2018 Open Enrollment What happens if I don t make an active choice? If you don t enroll between Monday, October 30, and Friday, November 17, you will be assigned to the default medical and dental options that may not be the best options for you You will automatically be enrolled in employee-only coverage in the Health Investment Option If you are enrolled in this default coverage, you will not be able to contribute to an FSA (Health Care or Limited Purpose) for 2018, and you will not be able to contribute initially to an HSA. You will not have dental coverage. Be sure to actively enroll to avoid default coverage. 31

32 Additional Medical Plan Features Opt-Out Credit If you decide to opt out of Fordham health insurance for 2018 you ll receive $75 every paycheck in calendar year 2018: You must show proof of coverage by attesting that you are covered under another Medical Plan 32

33 Resources

34 Resources Make an informed choice during this year s Open Enrollment. Use the following resources to help you determine which plan is best for your needs: Guide to the Enhanced Standard Option with Health Reimbursement Account Guide to the Health Investment Option with Health Savings Account Medical Plan Cost Estimator Videos All resources are found at fordham.edu/2018benefits and you can enroll at my.fordham.edu. If you have questions about the 2018 medical options, contact the Benefits Department at , Monday through Friday, 9 am 5 pm. 34

35 UHC Resources Manage your health and plan online and on-the-go at myuhc.com. Through UnitedHealthcare you have access to resources, including: Online access to care through myuhc.com or the Health4Me App The UnitedHealth Premium Designation Program shows you doctors who meet quality and cost-efficiency guidelines Help living with illnesses and conditions and access to leading healthcare facilities through the Centers of Excellence Network Help resolving a claim or finding care information with Advocate4Me To see other available resources, visit myuhc.com. Help if you have workrelated or personal issues through liveandworkwell.com 35 Support to reach your wellness goals through Rally

36 Medical Plan Cost Estimator 36

37 Medical Plan Cost Estimator 37

38 Medical Plan Cost Estimator 38

39 Questions?