2017 OPEN ENROLLMENT Presented to: Presented by:
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1 2017 OPEN ENROLLMENT Presented to: Presented by: 0
2 TODAY S AGENDA MEDICAL HEALTH PLAN OPTIONS HEALTH SAVINGS ACCOUNT (HSA) EDUCATION NEW HEALTH PLAN SELECTOR TOOL OTHER BENEFITS FLEX PLAN ADDITIONAL BLUE CROSS PROGRAMS DENTAL INSURANCE LIFE, VOLUNTARY LIFE, & DISABILITY PLANS 1
3 2017 HEALTH INSURANCE RENEWAL Benefits Advisory Committee Members Christopher Atzinger Faculty in Music Jacqueline Christensen Human Resources Myron Engle Information Technology Mike Goodson Human Resources Cleo Granneman AAA in English Travis Grant Human Resources Jan Hanson Finance Mark Koktavy Facilities Gregg Menning Committee Chair Facilities Steve O Neill Boe Counseling Jeff Partington Facilities Susan Smalling Faculty in Social Work and Family Studies Judy Tegtmeyer Faculty in Recreation, Exercise Science and Athletics 2
4 2017 HEALTH INSURANCE RENEWAL Renewal Process Blue Cross Blue Shield predicts healthcare costs for coming year They use our claims data for the last 2 years Expected Costs Predict a $1.9 million dollar increase from last year Equates to a 17.8% increase in costs Total of over $9.3 million for the plan year (September August) 3
5 2017 HEALTH INSURANCE RENEWAL Self Funded Insurance All employee healthcare expenses at St. Olaf are paid by the College and employees St. Olaf has historically paid about 70% of healthcare expenses Employees pay about 30% of healthcare expense» Premiums» Deductibles» Co-pays Stop/Loss Coverage is $225,000 per claim St. Olaf pays Blue Cross Blue Shield about $700,000 a year for stop/loss and other administrative fees 4
6 2017 HEALTH INSURANCE RENEWAL St. Olaf 3-Year Claim Expense Experience : $7 million ($5 million by St. Olaf and $2 million by employees) : $9 million ($6.5 million by St. Olaf and $2.5 million by employees) : Projected $8 million ($5.6 million by St. Olaf and $2.4 million by employees) : Projected $9.3 million total cost ($6 million by St. Olaf and $3.3 million by employees) 5
7 2017 HEALTH INSURANCE RENEWAL Verification of Blue Cross Blue Shield Process and Claims Analysis Associated Benefits and Risk Consulting is our new benefits broker Associated s own analytics team verified BCBS estimates were accurate Associated provided a range of options for the Benefits Committee to review 6
8 2017 HEALTH INSURANCE RENEWAL What levers do the Benefits Committee have to impact our benefit plan? Premiums (without changing plan design, i.e. deductibles, out of pocket maximums, etc. premiums would have to go up by 42%) Deductibles Out of Pocket Maximums Pharmacy drug co-pays Spousal limitations Change stop/loss coverage 7
9 2017 HEALTH INSURANCE RENEWAL History of Premium Increases at St. Olaf : 3.6% (BCBS recommended 10%) : 7.5% (BCBS recommended 17%) : 5% (BCBS recommended 16%) : 15% for Core Plan, 0% for HSA Plan (BCBS recommended 17.8%) 8
10 2017 HEALTH INSURANCE RENEWAL Core Plan Monthly Premium Comparison Rates (0.75 to 1.0 FTE) Total Premium Equivalent Employer Contribution Employee Contribution Employee $ $ $ Employee +1 $ 1, $ $ Family $ 1, $ 1, $ Rates (0.75 to 1.0 FTE) Total Premium Equivalent Employer Contribution Employee Contribution Employee $ $ $ Employee +1 $ 1, $ 1, $ Family $ 2, $ 1, $
11 DISCLAIMER Please note the following information is a summary of benefits and does not outline all of your benefits. If there is a discrepancy between information in this summary and the applicable Summary Plan Description or Certificate of Coverage, the Summary Plan Description or Certificate of Coverage prevails. 10
12 2017 HEALTH INSURANCE RENEWAL Renewal Decisions WILL RETAIN TWO MEDICAL PLAN OPTIONS Core Plan and High Deductible Health Plan Benefit changes to both plans PREMIUM CHANGES 15% increase to the Core Plan No change in premium to the HDHP/HSA Plan NO CHANGE TO NETWORK OF PROVIDERS Tier 1: Providers are less costly and provide highest level of benefit Tier 2: Providers are more costly and provide a lower level of benefits 11
13 2017 HEALTH INSURANCE RENEWAL Verification of Blue Cross Blue Shield Process and Claims Analysis Associated Benefits and Risk Consulting is our new benefits broker Associated s own analytics team verified BCBS estimates were accurate Associated provided a range of options for the Benefits Committee to review 12
14 CORE PLAN COMPARISON (IN-NETWORK) In-Network Tier 1 Tier 2 Deductible - Single/Family $750/$1,500 $1,250/$2,500 Coinsurance 25% 45% Out-of-Pocket Maximum - Single/Family $3,000/$6,000 $4,000/$8,000 Preventive Care You pay $0 You pay $0 Office Visits Convenience Care Urgent Care, Emergency Outpatient/Inpatient Hospital Care Prescription Drugs - Generic/Brand/Non-Formulary - Specialty Drugs 25% after deductible 45% after deductible 25% after deductible 45% after deductible 25% after deductible 45% after deductible $10/$45/$90 20% to a maximum of $200/script $10/$45/$90 20% to a maximum of $200/script 13
15 HDHP/HSA COMPARISON (IN-NETWORK) In-Network Tier 1 Tier 2 Deductible - Single/Family $2,600/$5,200 $3,000/$6,000 Coinsurance 20% 40% Out-of-Pocket Maximum - Single/Family $3,500/$7,000 $4,500/$9,000 Preventive Care You pay $0 You pay $0 Office Visits Convenience Care Urgent Care, Emergency Outpatient/Inpatient Hospital Care Prescription Drugs - Preventive Rx - Generic/Brand/Non-Formulary - Specialty Drugs 20% after deductible 40% after deductible 20% after deductible 40% after deductible 20% after deductible 40% after deductible You pay $0 20% after deductible 20% after deductible You pay $0 40% after deductible 20% after deductible 14
16 NEW TO THE HDHP/HSA! Preventive Rx Specific preventive prescription drugs paid at 100% Includes preferred generic and brand name drugs Treat conditions such as: High blood pressure High cholesterol Diabetes Asthma Contraceptives Breast cancer prevention And more! Please see the full list on St. Olaf s enrollment site! 15
17 HEALTH INSURANCE COSTS BY PLAN Core Plan Per Month >.75 FTE Employee $ $ Employee + 1 $ $ Family $ $1, HDHP/HSA Plan Per Month >.75 FTE Employee $ $ Employee + 1 $ $ Family $ $ Employee premiums are deducted on a pre-tax basis 16
18 WHAT IS A HEALTH SAVINGS ACCOUNT (HSA)?
19 HIGH DEDUCTIBLE HEALTH PLAN WITH A HSA Medical Plan Insurance Blue Cross Blue Shield Health Savings Account (HSA) Employer and Employee funded Employee owned Select Account 18
20 HSA BASICS
21 WHAT IS A HSA? A health savings account (HSA) is an account that you can use to pay medical expenses. Must be in conjunction with a high-deductible health plan (HDHP) You own the account, but both you and St. Olaf can contribute funds Tax-advantages: contribute pre-tax money, funds accrue tax-free and withdraw funds tax-free (if used for eligible medical expenses)
22 BENEFITS OF A HSA Triple tax advantage means you save money on your health care expenses Funds rollover each year, so you can use your HSA to save tax-free money for retirement You own the account, even if you leave St. Olaf Lower monthly premiums than the Core Plan HSAs can only be offered with a qualified high-deductible health plan (HDHP) Though the deductible is higher for this plan than the Core Plan, your monthly premium is lower. HSA funds can pay for medical expenses subject to the deductible/coinsurance and much more!
23 HOW DOES THE HSA/HDHP WORK You and St. Olaf contribute money to the HSA (either a lump sum payment or monthly through payroll deductions). You can use HSA dollars to pay your health insurance deductible and coinsurance, along with other qualified medical expenses such as dental or vision services. Once you meet your out-of-pocket maximum, the plan pays at 100%
24 WHO IS ELIGIBLE FOR AN HSA? Anyone who is: Covered by a HDHP Not enrolled in Medicare A, B or D Not covered under other health insurance* Not another person s dependent * Other health insurance does not include: specific disease or illness insurance, accident, disability, dental care, vision care and long-term care insurance
25 HSA CONTRIBUTIONS
26 HSA CONTRIBUTION LIMITS Each year, the IRS sets contribution limits These limits are for the total funds contributed, including company contributions, your contributions and any other contributions limits: $3,400 for individual coverage $6,750 for family coverage Enrollment Tier St. Olaf s Contribution Employee $500 Employee + 1 $1,000 Family $1,500 Annual Contribution Contribution is paid in two installments; the first ½ paid between Sept.1 and Jan. 31 and the second ½ between Feb. 1 and May 31.
27 HSA CONTRIBUTIONS MAXIMIZE YOUR TRIPLE TAX SAVINGS 2017 HSA Contribution 2017 IRS Max Contribution St. Olaf Contribution Your Potential Max Annual Contribution Single $3,400 $500 $2,900 Single + 1 $6,750 $1,000 $5,750 Family $6,750 $1,500 $5,250 Accountholders 55+ may contribute an additional $1,000 annually (also known as a catch-up contribution) YOU elect how much to contribute Employee contributions can be changed on a monthly basis
28 HSA CONTRIBUTIONS You are allowed to contribute the entire year s limit when you first become eligible for the HSA, as long as you are still eligible on the first day of the last month of your tax year (December 1 for most taxpayers). IRS 13 month rule: If you switch to the HDHP/HSA and contribute the maximum amount during the remainder of the calendar year (Sept.-Dec.) you must be enrolled in the HDHP/HSA for a minimum of 13 months. In order to contribute to (or receive the St. Olaf contribution) to your HSA beginning September 1, 2017, you must spend down your FSA to $0 by 8/31/17. If your spouse contributes to a full flex plan, you are likely ineligible to contribute to an HSA for the remainder of your spouse s flex plan year.
29 HSA INVESTMENT OPTIONS $10,000+ $1,000-10,000+ $1,000+ $1,000 minimum $0-$1,000 Basic Investment Account Self-Directed Brokerage Account Investment plan options A minimum of $1,000 required in Base Savings Account 28
30 HSA DISTRIBUTION RULES
31 HSA DISTRIBUTION RULES Distributions from your HSA are tax-free if they are taken for qualified medical expenses. Your HSA can only be used for expenses that are incurred on or after the date the HSA was established. However, HSA funds can be used for expenses from a prior year, as long as the expenses incurred on or after the date the HSA was established. For individuals age 65 and older, HSA distributions can be used for nonqualified medical expenses without facing the 20 percent penalty. However, income taxes will apply for non-medical distributions.
32 HSA DISTRIBUTION RULES HSA distributions can be taken for qualified medical expenses for the following people: The account holder (person covered by the HDHP) Spouse of that individual (even if not covered by the HDHP) Dependents of that individual (even if not covered by the HDHP)
33 QUALIFIED MEDICAL EXPENSES
34 QUALIFIED MEDICAL EXPENSES The IRS defines expenses that are considered qualified medical expenses for HSA distributions. Examples of qualified medical expenses include: Most medical care that is subject to your deductible and coinsurance (doctor visits, inpatient or outpatient treatment, durable medical equipment, etc.) Prescription drugs Over-the-counter drugs, only if you obtain a prescription Dental and vision care Select insurance premiums COBRA, qualified long-term care insurance, health insurance premiums paid while receiving unemployment benefits, health insurance after you turn 65 except for a Medicare supplemental policy
35 INELIGIBLE MEDICAL EXPENSES Expenses that are not considered qualified medical expenses include: Insurance premiums (other than the exceptions listed on the previous slide) Over-the-counter drugs (unless a prescription is retained from a physician insulin is an exception) Cosmetic surgery, teeth whitening Expenses covered by another insurance plan General health items such as tissues, toiletries, hand sanitizer If you use HSA funds for expenses beyond what the IRS defines as qualified, you will be subject to income tax on the distribution and an additional 20 percent penalty.
36 HOW DOES IT WORK? Medical Claim Visit provider Claim submitted to the insurance carrier by provider Insurance carrier applies the discount, processes the claim and sends you an EOB (Explanation of Benefits) You choose to pay your claim with HSA dollars (debit card) or pay out of your own pocket and save your HSA dollars Prescription drug (Rx) claim Obtain a prescription from your provider Pharmacist runs through insurance system and applies the discount You pay for the full cost of the prescription at the pharmacy with your HSA dollars (debit card), or pay out of your pocket and save your HSA dollars
37 QUESTIONS AND ANSWERS Q. How do I handle larger health care expenses earlier in the plan year, exceeding the amount deposited into the HSA? A. Pay the bill with your personal account, or use some form of credit to pay the bill if there are no funds available in HSA accounts. As funds become available in your HSA account, reimburse yourself from your HSA account. Many providers offer monthly payment plan options if your HSA is underfunded. Q. What proof do I have to provide to the HSA administrator, to prove that the money is being withdrawn for valid, qualified health care expenses? A. None. But, you must be prepared to prove withdrawals were for valid qualified expenses in the event of a tax audit. Q. What happens to my money if I leave my job? A. The money in your account belongs to you so you take it with you. You can spend it on future medical expenses, rollover into another HSA or save it.
38 PAYING FOR YOUR OUT-OF-POCKET EXPENSES WITH YOUR HSA Debit Card. When you open an HSA with SelectAccount, you are automatically enrolled with a SelectAccount debit card. Once activated, your HSA debit card can be used for eligible expenses up to your available HSA balance. Your medical spending account debit card is a convenient way to pay for medical expenses and to access your account, whenever and wherever, you need it. Simply use your debit card when you want to pay for eligible health care expenses. Money for the expense is transferred directly from your account to your provider or merchant. You don t have to pay cash up front, submit a claim form, or wait to be reimbursed. You can view account balances online, use our online planning tools, and view your past card transactions at Questions about your account call:
39 ONLINE MEMBER SERVICE CENTER MANAGING YOUR HSA IS EASY WITH SELECTACCOUNT.COM Register with the site to: View your account 24/7 via PC, tablet or mobile phone Pay health care providers from your HSA Request reimbursement for out of pocket expenses Check balance Make contributions View account activity e-vault receipt storage Request additional debit cards, add/change beneficiaries, manage investment funds 38
40 MOBILE ENABLED SITE MORE THAN AN APP, FULL WEBSITE ENABLED EXPERIENCE FROM ANY MOBILE DEVICE View your account 24/7 via PC, Tablet or mobile phone Pay health care providers from your HSA Request reimbursement for out of pocket expenses Check balance Make contributions View account activity Request additional debit cards, add/change beneficiaries, manage investment funds 39
41 WHICH PLAN IS RIGHT FOR YOU?
42 DID YOU KNOW? For the 9/1/15 through 8/31/16 plan year Core Plan Approximately 50% of individuals did not meet deductible Approximately 81% of individuals did not meet the medical out-of-pocket maximum Approximately 91.5% of individuals did not meet the prescription drug out-of-pocket maximum High Deductible Health Plan Approximately 86% of individuals did not meet the out-ofpocket maximum Prescription Drugs The average cost of a one month supply of a brand name drug is $250 The average cost of a one month supply of a specialty medication is $5,000 41
43 PLAN CONSIDERATIONS WHICH MEDICAL PLAN OPTION IS BEST FOR YOU? COMPARE DEDUCTIBLES (Tier 1) Core option - $750/$1500 deductible HSA option - $2,600/$5,200 deductible (can use St. Olaf s HSA contribution) COMPARE OUT-OF-POCKET MAXIMUMS (Tier 1) Core option - $3,000 single/$6,000 family HSA option - $3,500 individual/$7,000 family PRESCRIPTION DRUG COVERAGE Core Plan has Rx copays HSA plan subject to deductible with the exception of preventive drugs EMPLOYEE PREMIUM CONTRIBUTION Calculate by adding your costs and out of pocket maximum 42
44 WHICH MEDICAL PLAN IS RIGHT FOR YOU? Premium / potential savings: Enrollment Tier Core Plan Monthly Cost HDHP/HSA Monthly Cost Annual Premium Savings Employee $177 $144 $396 Employee + 1 $435 $362 $876 Family $678 $570 $1,296 Out-of-pocket exposure: Out-of-Pocket Maximum Core Plan (Tier 1) HDHP/HSA (Tier 1) Employee $3,000 $3,500 (minus $500 w/hsa contribution) Employee + 1 $6,000 $7,000 (minus $1,000 w/hsa contribution) Family $6,000 $7,000 (minus $1,500 w/hsa contribution) Talk to your pharmacy and/or your provider, explore generic alternatives 43
45 HEALTH PLAN COMPARISON TOOL WHICH MEDICAL PLAN OPTION IS BEST FOR YOU? Health Plan Selector Tool Online Cost Calculator Model your estimated health care expenses Analyze your net out-of-pocket costs St. Olaf s health plan options and premiums have been pre-loaded with Tier 1 benefits as well as premiums for FT employees Instructions Go to Username: stolaf Password: Benefits2017! Security question response: stolaf Please see step-by-step for additional instructions! 44
46 HEALTH PLAN COMPARISON TOOL WHAT YOU WILL NEED BEFORE GETTING STARTED What do I need for each family member? Approximate number of Professional Visits: Convenience Care visits (walk in clinics designed to treat minor conditions) Primary Care visits (family or general practice, internist, pediatrician) Specialty Care visits (cardiologist, oncologist, neurologist, psychiatrist) Urgent Care Visits Emergency Care Visits Planned hospitalizations Prescription Drug Usage Drug name Drug type (generic, brand name or non-formulary) Drug cost Number of scripts per year Request a claims resume from Blue Cross! 45
47 FLEXIBLE SPENDING ACCOUNTS
48 FLEXIBLE SPENDING ACCOUNTS (FSA) General Purpose (Full) FSA Available to those enrolled in the Core Plan Deduct money pre-tax to pay for eligible medical expenses not covered by the medical plan such as deductible, coinsurance, prescription drug copays, dental and vision expenses Limited Purpose FSA Available to those enrolled in the HDHP/HSA Deduct money pre-tax to pay for eligible dental and vision expenses only until deductible is met, then can also be used for medical expenses from that date forward. Both FSA Accounts $2,600 maximum contribution Plan year is 9/1 through 8/31 Use it or lose it You must elect to participate in the plan. Elections do not roll over from one year to the next. 47
49 FLEXIBLE SPENDING ACCOUNTS (FSA) Dependent Care FSA Available to any eligible employee, regardless of health plan election Deduct money pre-tax to pay for dependent care expenses $5,000 maximum contribution Plan year runs 9/1 through 8/31 Use it or lose it You must elect to participate in the plan. Elections do not roll over from one year to the next. 48
50 SERVICES AND SUPPORT TO HELP YOU MANAGE YOUR HEALTH
51 DOCTOR ON DEMAND Doctor On Demand allows you to see a board-certified physician from your smartphone, tablet, or computer, 7 a.m. to 11 p.m., 365 days a year, from wherever you need one. A video visit with a doctor is a quick, easy, no hassle way to get answers to your medical questions, diagnose a condition you are suffering from, and get a prescription as needed. 18 OF 20 OF THE MOST COMMON URGENT CARE CONDITIONS CAN BE TREATED BY DOCTOR ON DEMAND 87% RECOMMENDED TO FRIENDS & FAMILY $44 Approximate cost of visit Doctor On Demand is an independent company providing telehealth services and is not available in every state. Check DoctorOnDemand.com/bluecrossm to ensure you are located in a state that is eligible to participate. 50
52 STAY IN SHAPE WITH FITNESS DISCOUNTS Work out at a participating fitness center 8 times a month to qualify for the $20 credit There are thousands of participating fitness centers in the network go to members.bluecross.com to find a participating facility. To participate, you must complete an enrollment form and turn it into your workout facility 51
53 BLUE CROSS MEMBER PORTAL YOUR ONE-STOP ONLINE RESOURCE Track claims See deductibles and maximums View a summary of your costs Access the Find a doctor web tool Online access to health and wellbeing tools To get started, login or register using the URL on the back of your ID card. Ways to Save Alerts and Healthcare University (aka. SmartSelect Plus) are trademarks of Change Healthcare Corporation. 9
54 OTHER BENEFITS Dental Will remain with Delta Dental No change in benefits or employee premiums Employer Paid Life insurance Benefit will remain unchanged - 2x annual earnings up to $500,000 or limit it to $50,000 Voluntary Life & AD&D plans No changes to these voluntary offerings Long Term Disability St. Olaf college pays the premium on your behalf Elect YES if you want to pay the small tax on the premiums, allowing any benefit to be paid tax-free Elect NO if you do not want to pay the tax on the premiums, allowing any benefit to be taxed. You can make this change only during open enrollment
55 OPEN ENROLLMENT REMINDERS - Annual Open Enrollment: Beginning at noon on July 24 Noon on August 11 - This is your open enrollment opportunity Employees and their eligible dependents can come on and/or off the St. Olaf plans during this time - Can I make changes after open enrollment? Not without a qualifying event such as: o o o o Marriage Divorce Birth or adoption of a child Change in employment status which causes a change in eligibility - Changes must be made within 30 days of a qualifying event!
56 QUESTIONS? Open Enrollment Meeting Dates and Times: June 20 th at 9 am and 2 pm at Viking Theater July 13 th at 8:30 am and 2 pm at Viking Theater July 26 th at 9 am and 2 pm at Viking Theater Computer Lab Sessions Those needing assistance in enrolling, can come to Tomson 182 classroom, near the HR office on: July 25th from am and 2-3 pm July 27th at 10 am and 2 pm * August 2nd at 10 am and 2 pm * August 4th from am August 8th at 10 am and 2 pm * August 10th from am and 2-3 pm * Indicates assistance available in navigating the BlueCross/Blue Shield website and a new health plan comparison tool offered through Associated Benefits and Risk Consulting.
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