BENEFITS OPEN ENROLLMENT 2015 Open Enrollment is the one time during the year you can change your benefits for any reason. All changes go into effect 1/1/2015. IF YOU LIKE YOUR CURRENT BENEFIT CHOICES YOU DON T HAVE TO CHANGE A THING!
MEDICAL PREMIUMS 2011 2012 2013 2014 US avg Premium Increase: US avg Premium Increase: US avg Premium Increase: US avg Premium Increase: 9% 4% 3.3% 10% NACOG: NACOG: NACOG: NACOG: No increase No increase Vision 5% increase No increase
2015 PREMIUMS 2015 projected increase for US is on avg 8.6% We have to finally increase our rates: 2014 EE 2014 Family 2015 EE 2015 Family % Annually Annually Annually Annually Change Pd by NACOG PD by EE Pd by NACOG Pd by EE Medical $6,955.32 $5,622.96 $7,149.36 $5,888.40 4.5% Dental $ 365.88 $ 595.32 $ 377.88 $ 595.32 0 Vision $ 73.92 $ 84.84 $ 77.04 $ 88.56 4.3%
PREVENTIVE CARE $25 copay then 100% covered. 132 enrollees have used this benefit for 216 claims. Good start but We can do better! Blood pressure & diabetes type 2 screening, cancer screenings, screenings related to pregnancy, sexual health screenings, age related services such as osteoporosis screening, well-woman exams, and colorectal cancer and pediatric screenings including hearing, vision, and oral health NOTE: Always check with Meritain and your Doctor to ensure it is a covered preventative service. If it is a Diagnostic service, it will be treated differently. Always make sure that you are staying In- Network to get these services otherwise they will not be covered.
FLU SHOTS A Flu shot is considered Medical Preventive care and has a $25 copay. A Flu Shot at the Pharmacy must be paid up front and reimbursed by filing a claim.(it s not a RX) A Flu Shot at a clinic or Doctor s office is just the $25 copay.
PLAN ENHANCEMENTS Hearing Aids & exams covered up to a $1500 lifetime maximum. Bariatric surgery updated to cover current practices. ***Update*** on Friday, October 17, 2014 a federal judge struck down Arizona s ban on gay marriage. Expect changes to plan eligibility and ASRS. Note: these changes did not impact the rates enough to be the cause of the premium increase.
ENHANCEMENTS NOT ADOPTED Extend Dental and Vision to age 26. Expand drug coverage. Adding Plan tiers i.e. Employee +1 These added significant additional increases to the premium in addition to the 2015 increase.
PRESCRIPTIONS (Navitus) We are encouraging the use of Preferred Pharmacies will save the plan money and reduce overall plan expenses. Employee pays the same in co-pay regardless. Remember, you still save money by using Welldyne mail order for recurring prescriptions.
Examples of Preferred Pharmacies Walmart, Target, Costco, Sams Club, grocery stores. Non-preferred: Walgreens & CVS. Full list available from HR and on the Employee Portal.
Flexible Spending Account Put aside up to $2000 per year pre-tax to pay for out-ofpocket medical expenses and reduce your taxable income. You can use your FSA for family members even if you don t have family coverage. You can rollover up to $500 in leftover funds at the end of the year. Funds are available starting January 1, 2015 with an easy to use debit card. ($2.50/$3.00 per pay period fee) You MUST sign up again every year you want to participate or use your rollover amount.
Examples of FSA expenses Abortion Acupuncture Alcoholism Ambulance Annual Physical Examination Artificial Limb Artificial Teeth Bandages Birth Control Pills Body Scan Braille Books and Magazines Breast Pumps and Supplies Breast Reconstruction Surgery Capital Expenses Car Chiropractor Christian Science Practitioner Contact Lenses Crutches Dental Treatment Diagnostic Devices Disabled Dependent Care Expenses Drug Addiction Drugs Eye Exam Eyeglasses Eye Surgery Fertility Enhancement Founder's Fee Guide Dog or Other Service Animal Health Institute Health Maintenance Organization (HMO) Hearing Aids Home Care Home Improvements Hospital Services Insurance Premiums Intellectually and Developmentally Disabled, Special Home for Laboratory Fees Lactation Expenses Lead-Based Paint Removal Learning Disability Legal Fees Lifetime Care Advance Payments Lodging Long-Term Care Meals Medical Conferences Medical Information Plan Medicines Nursing Home Nursing Services Operations Optometrist Organ Donors Osteopath Oxygen Physical Examination Pregnancy Test Kit Prosthesis Psychiatric Care Psychoanalysis Psychologist Special Education Sterilization Stop-Smoking Programs Surgery Telephone Television Therapy Transplants Transportation Trips Tuition Vasectomy Vision Correction Surgery Weight-Loss Program Wheelchair Wig X-ray
Dependent Care Account Put aside up to $5000 pre-tax for eligible day care, before/after school care, day camp, preschool, and some in-home babysitting expenses. Can use for both dependent children 13 or younger or dependent children & adults incapable of self care. Funds available as you pay in. Must use a claim form, no debit card.
THE BIG NEWS! NEW CLAIMS ADMINISTRATOR Changing from Meritain to Gilsbar NO change in providers or benefits You will experience positive changes in your claims and customer service:
GILSBAR 2100 Covington Centre Covington, LA 70433 (800) 455-7227 www.gilsbar.com
GILSBAR No Phonetree you talk to a live human being when you call. Dedicated NACOG customer service staff and claims adjusters. New ID cards (you need to give it to all your medical and dental providers starting 1/1/15) New website: www.mygilsbar.com
Provides dedicated support during Open Enrollment. Helps members understand all the benefit options available. Can explain the benefits of a the FSA. Guides members in modeling their choices from a financial and coverage perspective Assists members with the completion of their enrollment form. They even answer Health Care Reform questions! Call (866)978-2032 Today!
NACOG WELLNESS Task Force started meeting in the spring. Basic design of program developed. Working with Gilsbar on integrating design with their wellness program and website offerings. Wellness plan components will integrate with Safety initiatives (i.e.: back safety, weight management). Team Challenges will start up again along with programs, webinars, incentives, and coaching.
NAME THE WELLNESS PROGRAM! CONTEST We need a snazzy, catchy name (and logo) for the Wellness Program so we are asking YOU to help us. The Task Force (and Chris Fetzer, ED) will choose the winner. Submit your entry(s) to csteers@nacog.org (or mail) by November 30 th. Great prize for the winner!
AFLAC No changes in plans being offered: Short Term Disability * Accident * Cancer Hospital * Illness * Life Remember you can only change/drop your policy during open enrollment or a qualifying event. AFLAC pays income replacement income directly to you, not a provider. Detailed information explaining the different plans is available at www.aflac.com Enroll/change your policy with agent Mark Hill at 928 772-8117.
ASRS Current rate is 11.60% (pre-tax).nacog matches 100% ASRS has a new & improved website. Create your personal account today. Head Start enrollment code is 66I00099 All others enrollment code is 4TN00076 TIAA-CREF is voluntary supplemental retirement savings program through ASRS. You can enroll at any time. Maximum is $17,000 per year.
OPEN ENROLLMENT SUMMARY Family premiums are increasing starting January 1, 2015. New Claims administrator means new card and website for 2015 and a better claims experience! Benefits changes must be in to Cathy Steers by November 26, 2014 FSA elections must be made every plan year! You can use www.healthcare.gov for employee or family coverage. NACOG s health plan meets or exceeds required coverage under the Health Care Reform therefore you do not qualify for subsidy if using healthcare.gov
POP QUIZ The new Claims Administrator is? You can cover dependents with Dental up to age 26. Yes or No? The capital of Tennessee is? The maximum amount for an FSA is? What do I do with the new ID card?