2018 OPEN ENROLLMENT. Presented by Marcie Gentry For Nebo School District

Transcription

1 2018 OPEN ENROLLMENT Presented by Marcie Gentry Fr Neb Schl District

2 IMPORTANT UPDATES New Benefits The medical plans will be mving t SelectHealth effective 9/1/18 Opticare will n lnger be ffered but will be replaced with VSP What is staying the same? Dental remains with EMI EyeMed remains a Visin ptin HSA Health Equity Life and AD&D Hartfrd Disability Cigna Vluntary Plans MetLife FSA Axis Plus Benefits Overview

3 SELECTHEALTH SHARE SelectHealth Share is designed t achieve better health, better care, and lwer csts by encuraging healthy lifestyles, prviding quality healthcare and supprting lwer, mre affrdable health insurance premiums. Fr Yur Physical Health

4 SELECTHEALTH SHARE The SelectHealth Share netwrk includes ver 5,100 prviders and 21 hspitals Fr thse emplyees residing in Juab Cunty, there will be a similar ptin made available t yu Fr Yur Physical Health

5 MEDICAL Prvider Netwrk Plan Year Accumulatrs Deductible embedded deductible Out-f-Pcket Maximum Preventive Care Office Visits Primary Care/Specialist Urgent Care Hspital Services Inpatient / Outpatient Emergency Rm Prescriptins Tier 1 Tier 2 Tier 3 Specialty Drugs SelectHealth Share Base Plan This plan has an embedded deductible which nly requires an individual t satisfy the single deductible and ut f pcket maximum, nt the entire family amunt Share $2,700 BASE PLAN Qualified HDHP Plan $2,700 per persn $5,400 per family $3,700 per persn $7,400 per family 100% Cverage 20% AD 20% AD 20% AD 20% AD After Medical Deductible is Satisfied $10 AD $25 AD $50 AD $100 AD AD = After Deductible Fr Yur Physical Health

6 MEDICAL Prvider Netwrk Plan Year Accumulatrs Deductible unembedded deductible Out-f-Pcket Maximum Preventive Care Office Visits Primary Care/Specialist Urgent Care Hspital Services Inpatient / Outpatient Emergency Rm Prescriptins Tier 1 Tier 2 Tier 3 Specialty Drugs SelectHealth Share Optin Plan This plan has an unembedded deductible. If yu enrll as a single, yu wuld nly be respnsible fr the single deductible. If yu enrll with dependents, the family deductible wuld have t be satisfied befre the insurance starts t pay this culd be met by just ne family member Share $1,600 OPTION Plan Qualified HDHP Plan $1,600 single $3,200 family $3,250 single $6,500 family 100% Cverage 20% AD 20% AD 20% AD 20% AD After Medical Deductible is Satisfied $10 AD $25 AD $50 AD $100 AD AD = After Deductible Fr Yur Physical Health

7 MEDICAL Premiums *Emplyees wrking less than full time will pay a higher mnthly premium related t the number f hurs they wrk. Cntact the HR ffice if yu are less than full time and want t knw yur exact premium. Status Ttal Premium Per Mnth (10 Mnths) $2,700 Deductible BASE Plan Neb will MATCH yur HSA cntributin fr Emplyee Only $25.00 $ Tw Party $85.00 $1, Family $ $1, Fr Yur Physical Health $1,600 Deductible OPTION Plan Emplyee Only $34.00 $ Tw Party $ $ Family $ $ Neb will match yur payrll deducted HSA cntributin up t this annual dllar amunt

8 IMPORTANT THINGS TO NOTE Benefits fr the Base plan have imprved with lwer deductible and ut f pcket maximums Benefits are In-Netwrk nly. N cverage if yu g utside the netwrk with the exceptin f ER r traveling Mnthly premiums fr mst individuals will be a rate reductin ver the current plan year BASE Plan Annual Savings OPTION Plan Annual Savings Single $25.00 $25.00 $0.00 $61.00 $34.00 $ Tw Party $ $85.00 $ $ $ $1, Family $ $ $ $ $ $1, Fr Yur Physical Health

9 MEDICAL Prvider Netwrk Plan Year Accumulatrs Deductible embedded deductible Out-f-Pcket Maximum Preventive Care Office Visits Primary Care/Specialist Urgent Care Hspital Services Inpatient / Outpatient Emergency Rm Prescriptins Tier 1 Tier 2 Tier 3 Specialty Drugs DUAL EMPLOYEES This plan has an embedded deductible which nly requires an individual t satisfy the single deductible and ut f pcket maximum, nt the entire family amunt Share $2,700 BASE PLAN Qualified HDHP Plan $2,700 per family $5,400 per family 100% Cverage 0% AD 0% AD 0% AD 0% AD After Medical Deductible is Satisfied $0 AD $0 AD $0 AD $0 AD AD = After Deductible Fr Yur Physical Health

10 MEDICAL Prvider Netwrk Plan Year Accumulatrs Deductible unembedded deductible Out-f-Pcket Maximum Preventive Care Office Visits Primary Care/Specialist Urgent Care Hspital Services Inpatient / Outpatient Emergency Rm DUAL EMPLOYEES This plan has an unembedded deductible. If yu enrll as a single, yu wuld nly be respnsible fr the single deductible. If yu enrll with dependents, the family deductible wuld have t be satisfied befre the insurance starts t pay this culd be met by just ne family member Share $1,600 OPTION Plan Qualified HDHP Plan $3,200 per family $3,200 per family 100% Cverage 0% AD 0% AD 0% AD 0% AD Prescriptins Tier 1 Tier 2 Tier 3 Specialty Drugs After Medical Deductible is Satisfied $0 AD $0 AD $0 AD $0 AD AD = After Deductible Fr Yur Physical Health

11 MEDICAL Premiums Status Premiums fr Dual Emplyees Ttal Premium Per Mnth (10 Mnths) $2,700/$5,400 Deductible BASE Plan Neb will MATCH yur HSA cntributins fr Tw Party $85.00 Family $ $1, ne time nn-match cntributin f $1,350 (divided ver 10 mnths) $1, ne time nn-match cntributin f $1,350 (divided ver 10 mnths) Tw Party $94.00 Family $ $3,200 Family Deductible OPTION Plan $ ne time nn-match cntributin f $800 (divided ver 10 mnths) $ ne time nn-match cntributin f $800 (divided ver 10 mnths) Neb will match yur payrll deducted HSA cntributin up t this annual dllar amunt Fr Yur Physical Health

12 IMPORTANT THINGS TO NOTE - Dual Benefits fr the Base plan have imprved with lwer deductible and ut f pcket maximums Benefits are In-Netwrk nly. N cverage if yu g utside the netwrk with the exceptin f ER r travelling Mnthly premiums are less than yu have been paying this past year fr bth plan ptins BASE Plan Annual Savings OPTION Plan Annual Savings Tw Party $ $85.00 $ $ $94.00 $1, Family $ $ $ $ $ $1, Fr Yur Physical Health

13 HOW DOES SHARE WORK? Members will have 9 Measured Engagements Establish a Health Savings Accunt and cntribute at least 25% f the annual deductible Create a My Health accunt Chse a primary care dctr n the SelectHealth Share netwrk and designate wh the dctr is in My Health Cmplete an annual nline health assessment, within the first 90 days f the plan year Attend a wrk-site health screening event (r btain the screening frm a physician) within the first 90 days (this will be available at the Benefits Fair n August 17 th ) Fr Yur Physical Health

14 HOW DOES SHARE WORK? Finish at least ne annual digital caching prgram Cmplete at least 2 f the wellness/activity campaigns accessed thrugh the Wellness Activities page in the Healthy Living prtal. Campaigns must be cmpleted befre the end f the insurance plan year (August 31, 2019) Get an annual preventive exam and/r screenings as recmmended by age and gender Participate in disease management with a SelectHealth r Intermuntain Healthcare care manager fr the fllwing cnditins: asthma, diabetes, Chrnic Obstructive Pulmnary Disease COPD, and cngestive heart failure Emplyees the chse nt t participate fully in the Share plan will be assessed a $200 penalty ($50 per mnth ver 4 mnths) Fr Yur Physical Health

15 SELECTHEALTH SHARE Other Requirements Enrll in the Weight t Health prgram, if needed Enrll in the Healthy Beginnings maternity prgram, when pregnant Cmplete the educatinal prtin f a tbacc cessatin prgram, if applicable Participate in Shared Decisin Mdule (SDM) as prescribed by physician Fr Yur Physical Health

16 SELECTHEALTH SHARE Emplyer Engagement Respnsibilities Offer a Qualified High Deductible Health Plan that meets the Share minimum benefit design Fund an emplyer-match HSA cntributin f 25% f the annual deductible Cntribute at least 70% f the premium based n least expensive plan ptin Meet the requirements f the SelectHealth Healthy Living prducts including: Establish a wellness cuncil Prvide a wellness incentive Cnduct quarterly ShapeUp Cre Challenges Supprt a tbacc-free envirnment Fr Yur Physical Health

17 WHY SHARE? Neb Schl District and participating emplyees will benefit by reducing the current medical premiums fr If the District and the members meet the utlined criteria, the District has a fixed renewal fr f 2.5% (current trend in the State f Utah is 10%) Fr the year, if criteria is met thrugh the Share plan, we are again guaranteed a 2.5% increase Grup must meet participatin requirements each year t receive the rate guarantee 50% 1 st year, 60% 2 nd year and 70% 3 rd year Neb emplyees are already ding mst f the wellness requirements Fr Yur Physical Health

18 QUESTIONS?