2018 Employee Benefits

Transcription

1 2018 Employee Benefits Medical. Dental. Vision. Disability. Life/AD&D. Voluntary. EAP. HSA/HRA

2 Contact Information Integra Insurance Services, LLC. Insurance Broker Servicing & Claims Dawn Gann (225) Office (225) Fax Escalated Issues Roxy Kugler (225) Office (225) Cell Medical P 3-7 Provider Name: Blue Cross Blue Shield of Louisiana Customer Service: (800) Local Phone Number: (225) Pharmacy Claims: (800) Provider Web Address: Policy Number: 78D04ERC Health Savings Accounts (HSA) P 8-10 Provider Name: NueSynergy Provider Phone Number: (855) Employer ID: Provider Web Address: Dental.P 14 Provider Name: MetLife Customer Service: (800) Provider Web Address: www. metlife.com Policy Number: Vision...P 15 Provider Name: MetLife Customer Service: (800) Provider Web Address: metlife.com Policy Number: Short-term / Long-term Disability / Life AD&D..P Provider Name: Sunlife Customer Service: (800) Provider Web Address: Policy Number: Employee Assistance Program P 18 Provider Name: ComPsych Qualified Counselors: (800) Provider Web Address: Company ID: EAPEssential Voluntary Benefits P 19 Provider Name: Colonial Life Customer Service: (800) Provider Web Address: Company ID: E

3 Medical Information Blue Cross Blue Shield of Louisiana Blue Saver HRA In-Network Out-of-Network Calendar Year Deductible Individual $4,000 / $8,000 Family (aggregate) $8,000* / $16,000 **when a contract includes more than one member, only the family aggregate deductible applies Maximum Out-of-Pocket Includes deductible and eligible coinsurance. Individual $6,350 / $12,700 Family (aggregate) $12,700 / $25,400 Coinsurance 80/20 In-Network 60/40 Out-of-Network Office Visits Deductible then Coinsurance Wellness Visits 100% Coinsurance Inpatient Services Outpatient Services Essential Health Benefits Deductible then Coinsurance Deductible then Coinsurance Deductible then Coinsurance Prescription Drug Card Generic Drugs Brand Name Drugs 80 / 20 coinsurance after deductible 60 /40 coinsurance after deductible Monthly Premiums Employee Only Employee + Spouse Employee + Child(ren) Family Employee Pays $60.00 $90.00 $80.00 $ Bank Pays $ $ $ $

4 Medical Information Blue Cross Blue Shield of Louisiana Employee Only Benefits Feature Annual Premium Deductible Coinsurance BlueSaver $ Employee Pays $3, Bank Pays $2,000 Employee $2,000 Bank Pays Bank Pays 80/20 Employee Pays 60/40 (OON) Employee Out-of-Pocket $2,000 Office Visit Prescription Drugs Deductible then Coinsurance 80/20 coinsurance after deductible for generics 60/40 coinsurance after deductible for brand-name If You Stay In-Network Employee Deductible $2,000 Bank Deductible (HRA,Bank Pays) $2,000 Coinsurance (HRA,Bank Pays) $2,350 BCBS Pays 100% 4

5 Medical Information Blue Cross Blue Shield of Louisiana Employee + Spouse Benefits Feature Annual Premium Deductible Coinsurance BlueSaver $1, Employee Pays $6, Bank Pays $4,000 Employee $4,000 Bank Pays Bank Pays 80/20 60/40 (OON) Employee Out-of-Pocket $4,000 Office Visit Prescription Drugs Deductible then Coinsurance 80/20 coinsurance after deductible for generics 60/40 coinsurance after deductible for brand-name If You Stay In-Network Employee Deductible $4,000 Bank Deductible (HRA,Bank Pays) $4,000 Bank Coinsurance (HRA, Bank Pays) $4,700 BCBS Pays 100% 5

6 Medical Information Blue Cross Blue Shield of Louisiana Employee + Child(ren) Benefits Feature Annual Premium Deductible Coinsurance BlueSaver $ Employee Pays $6, Bank Pays $3,500 Employee $4,500 Bank Pays Bank Pays 80/20 60/40 (OON) Employee Out-of-Pocket $3,500 Office Visit Prescription Drugs Deductible then Coinsurance 80/20 coinsurance after deductible for generics 60/40 coinsurance after deductible for brand-name If You Stay In-Network Employee Deductible $3,500 Bank Deductible (HRA,Bank Pays) $4,500 Bank Coinsurance (HRA, Bank Pays) $4,700 BCBS Pays 100% 6

7 Medical Information Blue Cross Blue Shield of Louisiana Family Benefits Feature Annual Premium Deductible Coinsurance BlueSaver $2, Employee Pays $8, Bank Pays $5,000 Employee $3,000 Bank Pays Bank Pays 80/20 60/40 (OON) Employee Out-of-Pocket $5,000 Office Visit Prescription Drugs Deductible then Coinsurance 80/20 coinsurance after deductible for generics 60/40 coinsurance after deductible for brand-name If You Stay In-Network Employee Deductible $5,000 Bank Deductible (HRA,Bank Pays) $3,000 Bank Coinsurance (HRA, Bank Pays) $4,700 BCBS Pays 100% 7

8 Health Savings Account (HSA)/ Health Reimbursement Account (HRA) NueSynergy Claims & Eligible Expenses Contact Information Customer Service (855) Website Address 4601 College Blvd. Ste 280 Leakwood, KS HSA Employee/Employer Funded Deductible, Coinsurance, and Other Eligible Medical Expenses Accessed via Debit Card or through Manual Claim Submission HRA Employer Funded Deductible and Coinsurance Accessed via Debit Card or through Manual Reimbursement Any Benefits Eligible Employee May Participate Funded By the Employee Through Payroll Deductions or Direct Contribution* Contribution Maximum of $3,450 for Individual Coverage and $6,900 for family coverage. Employees Covered Under B1Bank Health Plan are Eligible to Participate Funded Based on Employee Portion of Deductible Being Met NueSynergy login instructions will be provided prior to the start of the new plan year. Please be on the lookout for your NueSynergy Welcome . You may contact NueSynergy with any questions you may have prior to receiving your login access by calling (855)

9 Health Savings Account (HSA) What s an HSA An HSA is like a savings account. Participants can put aside money that can be used for eligible medical expenses, that then grows tax free, and rolls over every year. Who is eligible to participate? Participants enrolled in a qualified high-deductible health plan (HDHP), and who are not enrolled in Medicare part A or B, are eligible to contribute into an HSA. For participants who dis-enroll from their HDHP, they can still continue to use any available HSA funds, however, they would no longer be eligible to contribute into the plan, unless they enrolled into a new HDHP. Who owns the account? Any funds put into an HSA belong to the participant, regardless of where the account originated from. Should the participant leave an employer that hosts the HSA, funds are transferable, and still accessible to the participant. Is there a limit on how much can be contributed each year? Yes. Participants can contribute up to $3,450 for individual coverage, and up to $6,900 for family coverage. This includes contributions from themselves or from someone else, such as an employer. If you are 55 and older, you may contribute an extra $1,000. Can HSA funds be moved? Yes. Funds from an HSA account can be transferred or rolled over into a new HSA at any time. These funds will not count against your annual contribution limit. A tax penalty of 20% will apply when funds are withdrawn for reasons other than eligible medical expenses. Are funds forfeited if not used? No. There is no use it or lose it provisions under HSA, meaning funds roll over year-to-year. Funds contributed into the HSA remain in the account and are available for use regardless of the length of time they are not used, and regardless of HDHP status. 9

10 Health Savings Account (HSA) How are funds accessed? Funds are accessed through the use of a debit card or through manual reimbursement. Through NueSynergy, direct payment to providers is also available. Can funds be invested? Yes. Accounts with over $1,000 can be invested. Investment options are available through NueSynergy. Should HSA expenses be tracked? Yes. Participants should keep track of HSA transactions by keeping a record of health plan Explanation of Benefits (EOB s). Are there any tax benefits? Yes. HSA s provide many tax benefits, including reducing the participants taxable income, and allowing the participant to earn interest on tax free dollars. What are eligible expenses? As defined by the IRS, eligible expenses include deductibles, coinsurance, copays, prescription benefits, and in some instances, cost of long-term care insurance and Medicare Part A and Part B premiums. Additional resources are available at or by calling NueSynergy at (855)

11 Health Savings Accounts (HSA) Eligible Medical Expenses Eligible medical expenses are defined as those expenses paid for care as described in Section 213(d) of the Internal Revenue Code. Additionally, the IRS has allowed some over-the-counter drugs to qualify as eligible medical expenses. For a full list of these expenses, please refer to the IRS publication 502 or contact a tax professional. Abdominal Supports Abortion Acupuncture Air Conditioner* Alcoholism Treatment Ambulance Anesthetist Arch Supports Artificial Limbs Autoette* Rx Birth Control Pills Blood Tests Blood Transfusions Braces Cardiographs Chiropractor Christian Science Practitioner Contact Lenses Contraceptive Devices Convalescent Home Crutches Dental Treatment Dental X-rays Dentures Dermatologist Diathermy Diagnostic Fees Drug Addiction Therapy Drugs (Prescription) Elastic Hosiery* Eyeglasses Fees Paid to Health Institute Prescribed by Doctor FICA and FUTA Tax Paid for Medical Care Service Fluoridation Unit Guide Dog Gum Treatment Gynecologist Healing Services Hearing Aids and Batteries Hospital Bills Hydrotherapy Insulin Treatment Lab Tests Lead Paint Removal Legal Fees Lodging* Metabolism Tests Neurologist Nursing* Obstetrician Operating Room Costs Ophthalmologist Optician Oral Surgery Organ Transplant* Orthopedic Shoes Orthopedist Osteopath Oxygen and Oxygen Treatment Pediatrician Physician Physiotherapist Postnatal Treatments Podiatrist Practical Nurse for Medical Services Prenatal Care Prescription Medicines Psychiatrist Psychoanalyst Psychotherapy Radium Therapy Registered Nurse Special School Costs for the Handicapped Spinal Fluid Test Splints Sterilization Surgeon Telephone or TV Equipment fo r Assist the Hard-of-Hearing Therapy Equipment Transportation Equipment Ultraviolet Ray Treatment Vaccines Vasectomy Vitamins Wheelchair X-Rays *prior authorization may be required For a complete list of eligible expenses visit 11

12 Health Reimbursement Account (HRA) Employer funds used to pay for deductible and coinsurance. Note: Employee must meet his or her portion of the deductible for this benefit to pay. To Release Funds Explanation of Benefits Submitting Processing Time Reimbursement Track your claims through the year using NueSynergy s online claim process. NueSynergy will track your claims and automatically release HRA funds to you once you ve met your portion of the deductible. Blue Cross Blue Shield will send via mail, or you can find it online through your Blue Cross Blue Shield account. It is recommended that you submit each manual claim through your NueSynergy online account. This will ensure your claims are being tracked and substantiated properly. For card transactions you should login to your NueSynergy portal and submit your claim using the quick submit link. Should documentation be needed, an will be sent to you. NueSynergy processes claims within 48 hours. Funds cannot be released same day. You will be reimbursed any amount that is over your portion of the deductible. You can be reimbursed via check or direct deposit. Default setting is check, however you can register for direct deposit on your NueSynergy portal. Just because NueSynergy reimbursed you for a claim, does not mean you have paid the provider. You may request that NueSynergy pay your provider directly, by selecting this option during your initial claim submission. 12

13 Dependent Care Accounts (DCAP) Dependent Care FSA The Dependent Care FSA allows Business First Bank employees to use pre-tax dollars toward qualified dependent care such as caring for children under age 13 or caring for elders. The annual maximum amount you may contribute to the dependent care FSA is $5,000 (or $2,500 if married and filing separately) per calendar year. Some examples include: The cost of child or adult dependent care The cost for an individual to provide care either in or out of their house Nursery schools and preschools (excluding kindergarten) How to Access Your Funds The funds contributed to your FSA account may be accessed using a debit card provided by NueSynergy. Business First Bank pays all administration fees for the NueSynergy Plan Card services on your behalf. You are responsible for all NSF or overdraft fees associated with your personal account. If you choose not to use your debit card you may present your paper claims to NueSynergy for reimbursement. 13

14 Dental Insurance MetLife Calendar Year Benefits Description Benefit Information Network Deductible Annual Maximum PPO $50 (max 3 per family) **charged first visit of class B & C only $2,250 Class A, B, C Coinsurance 100/80/50/50 Preventative Services Routine Exams / Cleanings Prophylaxis Bitewing X-rays Full Mouth X-ray Fluoride to Age 16 Sealants to Age 16 Class A 100% with no waiting periods 1 every 6 months 1 every 6 months Max 4 films every 12 months 1 every 12 months 1 every 12 months 1 every 36 months Oral Cancer Screening 1 every 12 months for individuals over 40 Basic Services Space Maintainers to Age 16 Emergency Pain Class B 80% with no waiting periods* 1 every 24 months 1 every 12 months Simple Extractions / Fillings Major Services Anesthesia Oral Surgery Other Covered Procedures Class C 50% with 6 month waiting period Covered with complex oral surgery; subject to review Surgical Extractions & Impactations Non-Surgical Periodontics Inlays & Onlays Oral Surgery (surgical extractions & impactations) Crowns, Dentures, & Bridge Repairs Endodontics (Root Canals) Crowns, Bridges, Dentures & Endosteal Implants Orthodontics (children to age 19) Class D 50% with 6 month waiting period Ortho Lifetime Max of $1,000 *6-month waiting period for new enrollees with no prior coverage Monthly Premiums Employee Only Employee + Spouse Employee + Child(ren) Family Employee Pays $14.08 $31.88 $30.32 $54.70 Bank Pays $14.89 $33.30 $32.32 $

15 Vision Insurance MetLife Calendar Year Benefits Type of Service In-Network Out-of-Network Exam/Material Copay $10/10 copay Up to $45 Frame Allowance $130 Allowance Up to $70 Single Vision Lenses Covered by Copay Up to $30 Bifocals Covered by Copay Up to $50 Trifocals Covered by Copay Up to $65 Lenticular Covered by Copay Up to $100 Progressive Up to $55 Copay Up to $50 Contact Lenses (includes fit, follow-up & materials) elective Contacts Medically Necessary $130 Allowance Up to $105 Covered by Copay Up to $210 Employee Only Employee + Spouse Monthly Employee Premiums Employee + Child(ren) Family $5.23 $9.64 $10.10 $

16 Short-Term / Long-Term Disability Sunlife Business First Bank provides benefits eligible employees with short-term and long-term disability benefits, and pays the full cost of this coverage. In the event you become disabled from non-work related injury or sickness, disability income benefits are provided as a source of income. You are not to receive short-term disability benefits if you are receiving worker s compensation. Your Benefits Description Short-term Long-Term Benefits Begin 8 th day for accident 8 th day for illness 90 th day for accident 90 th day for sickness Benefits Payable Weekly Monthly % of Income Replaced Benefit Duration 67% of Pre-Disability Earnings 13 Weeks 66 2/3% of Pre-Disability Earnings The lessor of 2 years or ADEA option 1(policy certificate for details of ADEA option 1) Maximum Benefit $2,000 Weekly Max $10,000 Monthly Max Pregnancy Same as any Other Illness Same as any Other Illness **evidence of insurability may apply. 16

17 Life / AD&D Insurance Sunlife Business First Bank provides benefits eligible employees with basic life and AD&D coverage up to two times their salaries to a maximum of $250,000, and pays the full cost of this benefit. Description Your Benefits Coverage Type Guarantee Issue Amount Age Reductions Funded By Basic Life & AD&D Two Times Salary Up to $250,000* 65% at age 65 42% at age 70 27% at age 75 Employer *evidence of insurability may apply. 17

18 Employee Assistance Program (EAP) ComPsych (Sunlife) Business First Bank provides benefits eligible employees with an Employee Assistance Program through ComPsych. The program, known as, Guidance Resources, offers confidential counseling, financial information and resources, and work-life solutions at no charge to you. Description Confidential Counseling Financial Information & Resources Legal Support & Resources Work-Life Solutions Guidance Resources Online Stress, anxiety and depression Relationship & marital conflicts Problems with Children Job Pressures Grief and Loss Substance Abuse Getting out of debt Credit card or loan problems Tax questions Retirement planning Estate planning Saving for college Divorce & family law Debt & bankruptcy Landlord & tenant issues Real estate transactions Civil & criminal actions Contracts Child & elder care Moving & relocation Making major purchases College planning Pet care Home repair Timely articles Helpsheets Tutorials Child care, attorney, and financial planner searches 18

19 Voluntary Benefits Colonial Life Business First Bank provides benefits eligible employees with the option of participating in any of the voluntary benefits listed below. More information for each plan is available on the B1Bank Benefits Center, or by calling your agent at (225) Plan Description Accident This plan provides case benefits to the insured based on the accidental injuries and treatment received for those injuries. This plan covers direct and indirect medical expenses. Cancer This plan pays for direct and indirect expenses, including but not limited to, chemotherapy, antinausea medication, initial diagnosis, childcare, travel and lodging, stem-cell transplant, and much more. Life Insurance Additional life insurance can be purchased for yourself, your spouse, and any eligible dependent under the age of 18. Critical Illness This plan pays a lump sum benefit for members who are diagnosed with any of 9 specified diseases, including heart attack, stroke, kidney failure, blindness, and coma. (Please see plan brochure for full details). 19

20 Your Next Steps Completing Your 2018 Enrollment & Waiver Form All benefits eligible employees must complete and submit a 2018 Annual Enrollment & Waiver form. Employees are required to submit a form regardless of their intention of enrolling or waiving the coverage being offered. Please refer to the checklist below to ensure you have completed all of your requirements for the 2018 plan year. Step 1 Go to Step 2 Select the Enter My Enrollment button at the top of the page, and enter your password, B1Bank2018. Step 3 Complete your enrollment form, and submit. If you ve submitted correctly, you should receive a confirmation window letting you know your elections have been submitted. Make sure to submit your form no later than December 1 st! Step 4 Lookout for your election form that will come to you via your B1Bank address. Your election form will include a confirmation of all of your elections. Make sure to let your agent know should anything look inaccurate. Open Enrollment Deadline December 1st 20