Kyrene Employee Benefits Trust. Get benefits that make it easier to focus on your health, not your health care.

Transcription

1 Kyrene Employee Benefits Trust Get benefits that make it easier to focus on your health, not your health care.

2 HEALTH BENEFITS 7/1/17 What We Will Cover Today 1 Premium Plan Standard Plan Base Plan HSA Plan 5 6 Benefits to help you stay healthy FSA Coverage Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

3 HEALTH BENEFITS 7/1/17 Premium Plan Changes Effective 7/1/17 Individual out-of-pocket increased from $2,000 to $4,000, family increased from $5,000 to $10,000 Individual deductible increases from $0 to $200, family deductible increases from $0 to $400 Out-of Network coinsurance increased from 40% to 50% ER copay increased from $150 to $200 2 nd and 3 rd tier Prescription Copay increased from $5 $30 $60 to $5 $40 $80 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

4 HEALTH BENEFITS 7/1/17 Standard Plan Changes Effective 7/1/17 In-network individual out-of-pocket increased from $3,000 to $5,000, family increased from $8,000 to $13,000 Out-of network coinsurance increased from 40% to 50% ER copay increased from $150 to $200 2 nd and 3 rd tier Prescription Copay increased from $5 $30 $60 to $5 $40 $80 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

5 HEALTH BENEFITS 7/1/17 Base Plan Changes Effective 7/1/17 ER copay increased from $150 to $200 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

6 HEALTH BENEFITS OVERVIEW Premium Plan With the Premium Plan, you can use any doctor or hospital, but you save money when you use our national Choice Plus Network. There s coverage if you need to go out-of-network. There s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Preventive care is covered 100% in our network. Paying for network care Your Cost Virtual Care $0 PCP 10%* Convenience Care 10%* Specialist 10%* Urgent Care $25 then 10%* Emergency Room $200 then 10%* Hospital Stay $250 then 10%* DEDUCTIBLE Applies* Individual $200 Family $400 If you go out-of-network, your costs may be higher. Out-of-network providers can bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your Summary Plan Description. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. CO-INSURANCE 10% OUT-OF-POCKET LIMIT Individual $4,000 Family $10,000

7 HEALTH BENEFITS OVERVIEW Standard Plan With the Standard Plan, you can use any doctor or hospital, but you save money when you use our national Choice Plus Network. There s coverage if you need to go out-of-network. There s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Preventive care is covered 100% in our network. If you go out-of-network, your costs may be higher. Out-of-network providers can bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your Summary Plan Description. Paying for network care Your Cost Virtual Care $0 PCP 20%* Convenience Care 20%* Specialist 20%* Urgent Care $25 then 20%* Emergency Room $200 then 20%* Hospital Stay $250 then 20%* DEDUCTIBLE Applies* Individual $500 Family $1,000 CO-INSURANCE 20% OUT-OF-POCKET LIMIT Individual $5,000 Family $13,000 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

8 HEALTH BENEFITS OVERVIEW Base Plan With the Base Plan, you can use any doctor or hospital, but you save money when you use our national Choice Plus Network. There s coverage if you need to go out-of-network. There s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Preventive care is covered 100% in our network. If you go out-of-network, your costs may be higher. Out-of-network providers can bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your Summary Plan Description. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Paying for network care Your Cost Virtual Care $0 PCP 20%* Convenience Care 20%* Specialist 20%* Urgent Care 20%* Emergency Room $200 then 20%* Hospital Stay 20%* DEDUCTIBLE applies* Individual $5,000 Family $10,000 CO-INSURANCE 20% OUT-OF-POCKET LIMIT Individual $6,250 Family $12,500

9 HEALTH BENEFITS OVERVIEW Premium and Standard Plan Rx How we cover prescriptions. Myuhc.com Price a medication Refill Mail Order PDL Listing No-cost Contraceptive List Preventive Drug List Specialty Drug List Tier 1-$5 Lower-cost Medications Tier 2 - $40 Midrange-cost Medications Tier 3 - $80 Higher-cost Medications Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

10 HEALTH BENEFITS OVERVIEW Base Plan Rx How we cover prescriptions. Myuhc.com Price a medication Refill Mail Order PDL Listing No-cost Contraceptive List Preventive Drug List Specialty Drug List Tier 1-$5 Lower-cost Medications Tier 2 - $35 Midrange-cost Medications Tier 3 - $70 Higher-cost Medications Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

11 Health Savings Account Plan We need to encourage more informed healthcare decisions: People are currently removed from the true cost of health care Health care costs are skyrocketing There s a need to save for future health care costs This plan allows you the option to open a health savings account (HSA). If you have Employee Only coverage the district will contribute $648 to your account over the course of the year. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

12 HEALTH BENEFITS OVERVIEW HSA Plan With the HSA Plan, you can use any doctor, or hospital but you save money when you use our National Choice Plus Network. You can also save money when you use a health savings account (HSA) to pay for qualified services. Save money by staying in our network. There s no need to choose a primary care provider (PCP) or get referrals to see a specialist. Preventive care is covered 100% in our network. If you go out-of-network, your costs may be higher. Out-of-network providers can even bill you for amounts higher than what your plan will cover. For COVERAGE DETAILS, see your official health plan documents. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group. Your Cost Paying for network care Virtual Visit 20%* PCP 20%* Convenience Care 20%* Specialist 20%* Urgent Care 20%* Emergency Room 20%* Hospital Stay 20%* DEDUCTIBLE APPLIES* Individual** $1,500 Family $3,000 CO-INSURANCE 20% OUT-OF-POCKET LIMIT Individual** $3,425 Family $6,850 **Doesn t apply if 2+ members covered

13 HEALTH BENEFITS OVERVIEW HSA Plan How we cover prescriptions. Members are subject to their Medical/Pharmacy deductible before coinsurance apply. Select contraceptives are no cost Medications listed on Core Preventative Drug List are covered at 100% Tier 1-20% Lower-cost Medications Tier 2 20% Midrange-cost Medications Tier 3-20% Higher-cost Medications Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

14 HEALTH BENEFITS OVERVIEW Health Savings Accounts (HSA) It s a real bank account with Triple Tax Benefits You don t pay federal, state or FICA tax on the money you deposit. Your savings grows tax free and you can use tax free money for qualified expenses. You can build savings for retirement Anyone can contribute. No use it or lose it rule. You can invest savings. The money is there when you need it Use your UnitedHealthcare HSA MasterCard debit card to pay at the pharmacy, doctor s office. Or save it, the money in your HSA is yours, so it stays with you if you change health plans, employers, or retire. Save your receipts for all qualified medical expenses Non qualified expenses subject to a 20% tax penalty Qualified expenses : Doctor office visits Prescriptions Eyeglasses and contacts Dental care and braces Spouse and Children Medicare and COBRA premiums Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

15 HEALTH BENEFITS OVERVIEW Optum Bank SM Open your HSA with Optum Bank SM, Member FDIC An HSA MasterCard debit card to make it easy to pay Checks (optional, $10 for 25) Easy online bill payment and reimbursement Investment options to grow your retirement savings. Payroll deduction: Pre-tax dollars are taken out of your paycheck and deposited into your HSA. The district will provide you a URL link to open your bank account with OptumBank during Open Enrollment The national leader in HSA banking with more than a million accounts Access through myuhc.com or optumbank.com Three different account types. Health eaccess -Monthly Maintenance Fee $1 if balance is $1-$499, $0 if over $500 Health esaver Health einvestor Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

16 BENEFITS HSA Eligibility You must be eligible to open or fund a Heath Savings Account (HSA) You must be enrolled in a high-deductible health plan (HDHP). You cannot be covered by any other traditional health plan including Medicare or TRICARE You are not claimed as a dependent on someone else s tax return You are not covered by a health care flexible spending account (FSA) The IRS limits how much you can put into your HSA each year. The 2017 limits are: $3,400 for individual coverage $6,750 for family coverage Are you 55 or older? You can put in an extra $1,000 this year. Some other restrictions apply. Please consult a tax, benefits, or financial advisor.ave your receipts for all qualified medical expenses Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

17 How the HSA Plan Works - Chris Chris chooses the HSA Plan for himself because: No monthly premiums No chronic conditions Chance to save HSA to save for future medial expenses Type of Cost HSA Plan Yearly Premium $0 HSA Contribution received from district $648 Sick visit to PCP -$80 Preventive Care Visit $0 Urgent Care Visit -$120 Pay with your HSA or another way HSA Balance at End of Year $448 Money saved by enrolling in HSA over the Premium Plan. $2,388 $648+$1740 Individual $1,350 / Family $2,750. Preventive care is covered 100% when you use a network doctor. Money saved by enrolling in HSA over the Standard Plan Money saved by enrolling in HSA over the Base Plan $1,092 $648 +$444 $648 $648

18 How the HSA Plan Works - Jane Jane chooses the HSA Plan for herself because: No monthly premiums Saves on taxes Chance to save HSA for Retirement Type of Cost HAS Plan Yearly Premium $0 HSA Contribution $648 Emergency Surgery -100,000 Out of pocket Max $3,425 Net Out of pocket $2,777 HSA Balance at End of Year $0 Pay with your HSA or another way Individual $1,350 / Family $2,750 Money saved enrolling in HSA over the Premium Plan. Money saved by enrolling in HSA over the Standard Plan. $2,963 $648 +$1,740+($4,000 -$3,425) $2,667 $648+$444+($5,000-$3,425) Money saved by enrolling in HSA over the Base Plan. $3,473 $648+($6,250-$3,425)

19 OTHER BENEFITS Manage your health benefits and HSA at myuhc.com. Find network providers 800,000+ doctors and health care professionals Track claims and expenses. Estimate health care costs The UnitedHealth Premium Designation Program shows you doctors who meet quality and cost-efficiency guidelines. Check HSA balance Reimburse yourself for qualified expenses paid out-of-pocket Manage HSA investments Pay health care bills Discounts on acupuncture, chiropractic care, massage therapy and natural medicine myuhc.com Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

20 NETWORK Online access to care A virtual visit lets you see and talk to a doctor from your mobile device or computer No driving or crowded waiting rooms - 24/7 access Log in to myuhc.com or the Health4Me app to learn more HAS Plan member pays full cost of virtual visit until deductible is met Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

21 UnitedHealthcare Preventive Network preventive care is covered 100% One physical checkup every year One OB/GYN checkup every year (Pap Smear) One screening for breast cancer every year (mammogram) Shots for measles and other childhood diseases (Immunizations) One colonoscopy cancer screening test every five years Other preventive tests required by the Affordable Care Act Preventive Care website Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

22 OTHER BENEFITS Help is a call away. Care24 Nurseline is open 24/ Call or web chat with a registered nurse, master s-level counselor, or legal or financial professional 24/7 3 face-to-face visits with network clinician Help coping with grief, stress, relationship issues, and more Financial management information Legal support Find a doctor or counselor Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

23 FSA Understanding FSAs Through your employer, you choose to set aside money, tax-free, to pay for medical or dependent care expenses. You decide how much of your wages you want taken out of your paycheck and put into an FSA. You don t have to pay taxes on this money. The federal government and your employer can limit the amount you can put in. There is no carry-over of FSA funds. What you don t spend, you will lose. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

24 FSA How FSAs work 1. Estimate your expenses for the year. Decide how much money you want to set aside in your FSA. 2. Enroll when you enroll in your benefits. You must re-enroll each year. 3. Money will be set aside into FSA from each paycheck after the plan year starts. You pay no taxes on that amount. 4. As you pay for eligible expenses, you reimburse yourself from your FSA. Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

25 FSA OTC medicines and drugs require a valid prescription Your FSA will come with the Health Care Spending Card Debit MasterCard to make paying easy Health Care FSA You can set aside $2,600 for 2017 Use it for medical, dental and vision expenses such as: Doctor s office visit costs and procedures, including co-payment, co-insurance and deductible costs Eyeglasses, contact lenses and supplies and vision exams Dental treatments, including X-rays, cleanings, fillings and orthodontic treatment Covered prescriptions Over-the-counter (OTC) supplies and equipment, such as insulin Keep your receipts Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

26 FSA Keep your receipts Dependent Care FSA You can set aside $5,000 for 2017 Use it for eligible child care and elder care expenses, such as: Before and after school programs, including extended care programs Babysitter (work-related, in your home or someone else s home) Child care, nanny or Au Pair Nursery school, pre-school Adult day care Elder care (when you work and in your home) Travel costs to and from eligible care if provided by your care provider Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

27 Open Enrollment April 17 May 5, 2017 Great News! No Premium Rate Increases on Vision, Short-term Disability and our Life Insurance Plans. Cigna Dental; offers two plan choices DHMO (formerly Prepaid) plan PPO Dental plan Choosing the DHMO plan? Please call Cigna Dental to select a dentist and to get the Provider/Facility ID # for your dentist if you are electing the DHMO dental plan. You will need to enter this number when you enroll. PPO dental does not require a number to be entered, as you can see any dentist. For dental questions & provider info call: (800CIGNA24) 27 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

28 WIN ON WELLNESS (WOW) WOW Initiatives Funded by Wellness Budget Provided by UHC Rally is our interactive online wellness program that makes earning rewards easy!* Employees who are covered by a Kyrene/ UHC medical plan, can earn up to $250 each school year by completing three wellness related tasks under the Health & Wellness tab on their personal website. *Complete your Rally tasks for 2016/17 by June 30 th and you can start earning your Rally rewards for 2017/18 in July! Annual Win on Wellness Opportunities: FREE Individual Health Coach Sessions with Bre Moro from Welcoaz Mobile On-site Mammography (MOM) Fall & Spring Annual Fall Health Expo with free health screenings Real Appeal NEW PROGRAM through UHC for weight loss/management launching in 2017/2018! FREE Yoga Classes 28 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

29 Voluntary Benefit Plans Vision Avesis, No rate increases for vision plan. Many retail providers, including Nationwide, Eye Masters and COSTCO Dental Cigna Dental, Two plan options no cost increase, DHMO (Prepaid plan) and PPO Short-term Disability Insurance Policy Assurant, same great premium rates. Change in elimination period: medical leaves of absence which exceed 14 days and accidents that exceed 7 days, plan pays up to 6 months with physician certification Long-term Disability through ASRS, Sedgwick CMS, for disabilities greater than 6 months, employees 20 hours or more are automatically enrolled for this plan. Optional 403b/ 457b retirement plans through Voya 29 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

30 Voluntary Benefit Plans Life Insurance The Hartford, No premium rate increases Employer Paid Basic Life Insurance Policy $50,000 Option to purchase additional voluntary life for self and family Critical Illness / Accident Insurance Cigna new coverage offering began in 2016 Plans can be purchased to offset costs in the event of unexpected illnesses and accidents for the employee and their family Low group rate premiums Flexible Spending UnitedHealthcare Pre-tax Savings $2,600 can be withheld from pay annually for medical expenses $5,000 can be withheld from pay annually for dependent care service expenses (i.e. daycare and eldercare) 30 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.

31 Online Enrollment is Mandatory Who is required to log in to complete open enrollment? Every employee who is benefit eligible now is required to reenroll each spring for the next school year. Waiving all insurance through Kyrene? You must still log in to the online portal in ivisions to submit your waiver through the benefits enrollment process.* If you receive s from Employee Benefits during the open enrollment window of April 17, 2017 to May 5, 2017, be sure to read them as they may have information that is specific to you. Thank you! * To demonstrate the districts compliance with the Affordable Care Act showing the appropriate offer of medical coverage, all employees must complete the annual online process. An employees failure to complete the online enrollment when eligible results in autoenrollment into the Base PPO medical plan, employee only medical coverage which has a $5,000 annual deductible and would become the employees primary insurance plan. 31 Proprietary Information of UnitedHealth Group. Do not distribute or reproduce without express permission of UnitedHealth Group.