Date 00, 2011 Open Enrollment
What I ll cover Important Open Enrollment dates What s changing in 2012 What you ll sign up for during Open Enrollment Overview of two new medical plans Overview of prescription drug coverage, vision coverage and dental plan options Additional changes and offerings for 2012 What s staying the same Now what?
Open Enrollment timeline Oct. 15 Associate Benefits Handbook on LifeNet and Associate Resource Center (www.sths.com/hr) Oct. 24, 25 & 26 SmartHealth representatives at Baptist Hospital, Metro Center, MTMC, the Network Service Center and Saint Thomas Hospital Oct. 31 Open Enrollment Begins Nov. 14 Last day for Open Enrollment
Terms to remember SmartHealth - the new medical plan for Saint Thomas Health. It is our own Ascension Health plan with access to MissionPoint Health Partners MedImpact - provider of prescription drug coverage through SmartHealth s medical plans MissionPoint Health Partners a coordinated network of physicians and facilities that will provide STHe associates with assistance navigating the health care system and improving overall wellness.
What s changing in 2012? Two new medical plan options New prescription drug coverage provider with adjusted co-payment levels Age limit increase and maximum benefit change calculation with dental plan options Increased vision plan coverage Different buy-up options with Short-term and Long-term Disability plans
What decisions do I have to make? Medical plan option Vision Care coverage Dental Care coverage Short term disability Long term disability Basic Life and Accidental Death and Dismemberment Insurance with the option to sign up for additional coverage for yourself and your spouse Healthcare Spending Account Dependent Care Spending Account Legal Services plan
Can I make changes after Open Enrollment? The benefit elections you make during Open Enrollment will be in effect from Jan. 1, 2012 until Dec. 31, 2012. The only time you may change your selections during that time would be if You have a qualified change in family status You report that change within 31 days of the event, and The election you make is consistent with your change in family status.
What are my medical plan options? The Plan A Allows you to pay more of your share of the costs in premiums rather than when you need care. Higher Premium Lower deductible and out-of-pocket expenses The Plan B Allows you to pay less in premiums and more of the costs when you need care. Lower Premium Higher deductible and out-of-pocket expenses
Things to consider
What is MissionPoint Health Partners? MissionPoint Health Partners is a coordinated network of physicians and facilities focused on improving the wellness of STHe associates. This is accomplished by: Patient Centered Care Health Partners Quality Measures
What do I need to do to take full advantage of MissionPoint Health Partners? After Open Enrollment, select a Primary Care Physician from the MissionPoint network Only MissionPoint PCPs are participating in the medical home model of care. Work with your assigned Health Partner throughout the year to receive the most benefits, savings and quality care improvements
Here s how the medical plan options work
Terms to remember Tier 1 Providers - An expanded network of our new MissionPoint physicians and facilities. When you use Tier 1 providers, you get a greater benefit the highest level of benefits for the lowest cost because we are a health care provider, and these are our network physicians. Tier 2 Providers Additional members of Saint Thomas Health s physician network that have chosen not to participate in MissionPoint. This network is available because we recognize that at times you may need care that is not available from a Tier 1 provider. Although you will pay more than if you stay in Tier 1, SmartHealth s Tier 2 coverage is competitive with other employers in the area. Tier 3 Providers - These are providers that are out-of-network who are not contracted with SmartHealth. Tier 3 benefits will provide some coverage if you are not able to use a network provider.
What does this look like? Plan A Costs when you need care Hospital Stay Example: Let s say you elect Plan A, Associate Only coverage, and have a hospital stay costing $16,000. See the difference a network makes. Tier 1 Network (MissionPoint) You Pay: Deductible........$250 10% of remaining charges = $16,000-$250 = $15,750 $15,750 x.10 = $1,575 capped at OOP Max.. $1,500 Tier 2 Network (In-Network) You Pay: Deductible..$500 20% of remaining charges = $16,000-$500 = $15,500 $15,500 x.20 = $3,100 capped at OOP Max... $3,000 Tier 3 Non-Network You Pay: Deductible.. $3,000 50% of remaining charges = $16,000-$3,000 = $13,000 $13,000 x.50 = $6,500 capped at OOP Max...$6,000 Total for a $16,000 hospital stay You Pay $1,750 Plan Pays $14,250 You Pay...$3,500 Plan Pays $12,500 You Pay....$9,000 Plan Pays $7,000
What does this look like? Plan B Costs when you need care Hospital Stay Example: Let s say you elect Plan B, Associate Only coverage, and have a hospital stay costing $16,000. See the difference a network makes. Tier 1 Network (MissionPoint) You Pay: Deductible.. $500 20% of remaining charges = $16,000-$500 = $15,500 $15,500 x.20 = $3,100 Capped at OOP Max.$2,000 Tier 2 Network (In-Network) You Pay: Deductible...$800 30% of remaining charges = $16,000-$800 = $15,200 $15,200 x.30 = $4,560 capped at OOP Max.. $3,000 Tier 3 Non-Network You Pay: Deductible $3,000 50% of remaining charges = $16,000-$3,000 = $13,000 $13,000 x.50 = $6,500 capped at OOP Max.$6,000 Total for a $16,000 hospital stay You Pay. $2,500 Plan Pays $13,500 You Pay..$3,800 Plan Pays $12,200 You Pay..$9,000 Plan Pays $7,000
What is my premium payment?
Prescription drug coverage
Dental plan options
Vision plan changes Co-pay for annual vision exam will decrease from $15 to $10. New frames will be allowed every 12 months. Dependent children will be eligible for coverage up to the age of 26.
Other changes Short-term Disability/Long-term Disability coverage (STD/LTD) In 2012, the Basic STD/LTD coverage will provide 50% benefits at no cost with the option to buy-up to 70% coverage. In 2012, part-time associates will become eligible for self-paid STD and LTD coverage. The STD weekly maximum of $1,500 will be removed.
Other changes Healthcare and Dependent Care Flexible Spending Accounts Minimum annual election of $260
New benefit option: Hyatt Legal Plan The Hyatt Legal Plan offers you and your family easy and low-cost access to a wide variety of personal legal services. For additional information, call the Employee Service Center at 222.7847.
What s not changing? Basic Life and Accidental Death and Dismemberment Supplemental Life Spouse Life Child Life Supplemental Accidental Death and Dismemberment
Now what? Refer to the 2012 Associate Benefits Handbook located on LifeNet and the Associate Resource Center (www.sths.com/hr). Call the Employee Service Center at 222.7847. Oct. 24, 25 & 26 SmartHealth representatives at Baptist Hospital, Metro Center, MTMC, the Network Service Center and Saint Thomas Hospital All associates must make their 2012 benefit selections during Open Enrollment from Oct. 31-Nov. 14!
How to enroll in benefits Go to MyLifeWorksOnline Human Resources computers LifeNet Internet www.sths.com/hr Enter your UserID and password UserID: 10-digit employee number Password: STHS* plus the last four digits of your social security number (STHS*1234) Click on Self Service Click on New Benefits Enrollment Submit your selections! If you have questions during enrollment, please call the Employee Service Center at 222.7847. They are open Monday through Friday from 7 a.m. to 4 p.m.
What if I don t enroll in benefits during Open Enrollment? You will be assigned default coverage for 2012. Medical Plan A associate only coverage Basic Life and Accidental Death & Dismemberment coverage STD/LTD 50% coverage for full-time associates only
Date 00, 2011 Open Enrollment