Open Enrollment November 1 30, 2017 Changes take effect January 1, 2018 BG 11-9-2017
What benefits do I have now? Log into Employee Self Service (ESS) Link is on HR home page and Inside UAMS intranet. Select Benefits Benefits Participation Overview shows what you have as of today. Change date to see past or future benefits. UAMS Benefits Statement shows all benefits, including ones you don t have. Use this one so you know what to do during open enrollment. You can print it.
What changes can I make? Open enrollment affects: Medical Dental Vision Optional Short Term Disability Optional Long Term Disability Flexible Spending Accounts Can apply any time of year: (but subject to health questions and approval by insurance company) Optional Life Insurance Dependent Life Insurance Open enrollment all year, enroll or change anytime: - Accidental Death and Dismemberment - Home/Auto Liberty Mutual - Prepaid Legal LegalShield - Identify Theft Protection ID Watchdog - How much you save for your retirement
Open Enrollment Forms, Resources THE go-to place is the Open Enrollment link on our home page, hr.uams.edu. Copies of all communications from UA System and UAMS HR Rates Webinars, PowerPoint slides Open enrollment forms for Medical, Dental, Vision Instructions to enroll in ESS for Disability, FSA Benefits Fair on Wed, Nov 15. 9am-3pm, ground floor Ed 2
What s new for 2018? 2 new medical plans: Premier and Health Savings Plans replace Point of Service. Current POS members will automatically move to Classic unless elect new plan. New dental plan administrator from Delta Dental of Arkansas to Arkansas Blue Cross & Blue Shield New dental benefit for children under age 18: 50% orthodontia coverage, $2000 lifetime max per child Medical FSA max increases to $2600 Increase of $5-$10 in copays for specialist, urgent care center, and tier 2 and 3 rx copays in Classic plan SmartCare offered to all UA campuses
Medical Plan Options Classic remains the primary plan Closed network, similar to HMO. No benefits if go out-ofnetwork, except for emergencies. NEW Premier is a gold plan Lowest out of pocket expense at the doctor/hospital and simpler benefits. But highest premium deduction. Benefits available out-of-network. NEW Health Savings Plan is a qualified high deductible plan paired with a pretax Health Savings Account (HSA) Highest out of pocket expense at the doctor. But lower premium deduction. Benefits available out-of-network.
Why the changes? UA System, consultant, and system-wide benefits committee surveyed other universities in the region to see if we were positioned competitively High deductible/consumer driven health plans no longer new and offered by many employers now as an option or perhaps the sole plan Need for a richer benefit plan option POS was identical to the Classic plan for in-network benefits, no longer needed UA pays higher subsidy for family coverage, but slightly lower subsidy for employee coverage
Same for all 3 plans Self-funded by University of Arkansas, claims paid by UMR Preventive care covered at 100%, compliant with ACA, if you go in-network. Includes: Annual wellness/physical exam Cancer screenings (prostate, mammogram, colonoscopy) Well baby care Flu shots, shingles age 60+ Ancillary services provided by UMR and the University, such as: Disease Management discounts (diabetes, healthy heart, tobacco cessation, maternity) 24 Hour Nurseline
What doctors can you use? Network of providers is same and is nation-wide. Outside of Arkansas, providers are available in every state. Examples: Houston Methodist, Texas Children s, MD Anderson, Emory University Medical Center, Barnes-Jewish, OSU Medical Center, Tufts, Mayo Clinic. In Arkansas UAMS, NW Regional, Washington Regional, Sparks, St. Vincent s, Baptist, Ark. Heart Hospital, Ark. Children s Hospital and Ark. Surgical Hospital. Search for a provider online at www.umr.com Rarely does someone go out of network. If that is important to you, pick either Premier or Health Savings Plan. But a separate deductible, separate out-of-pocket max and higher coinsurance percentage (50%) would apply.
Body 3 Medical Plans at a glance
Employee Premium Costs MEDICAL Monthly POS Biweekly CLASSIC - employee only $ 104.50 150.50 $ 48.23 CLASSIC - employee + spouse $ 237.50 339.50 $ 109.62 CLASSIC - employee + child(ren) $ 195.50 279.50 $ 90.23 CLASSIC - employee + spouse + child(ren) $ 331.00 475.00 $ 152.77 HEALTH SAVINGS - employee only $ 74.26 $ 34.27 HEALTH SAVINGS - employee + spouse $ 169.98 $ 78.45 HEALTH SAVINGS - employee + child(ren) $ 140.34 $ 64.77 HEALTH SAVINGS - employee + spouse + child(ren) $ 238.40 $ 110.03 PREMIER - employee only $ 172.97 $ 79.83 PREMIER - employee + spouse $ 455.44 $ 210.20 PREMIER - employee + child(ren) $ 347.90 $ 160.57 PREMIER - employee + spouse + child(ren) $ 600.64 $ 277.22
Employee only coverage Classic - $104.50 premium No change from what you re paying today in this plan Health Savings - $74.76 premium $30.24 less @ month, $362.88 less @ year You have to commit to funding your HSA in this plan Would it be a financial hardship to pay all your medical expenses (including full cost rx) until you meet $2700 deductible? Premier $172.97 premium $68.47 more @ month, $821.64 more @ year Lower out-of-pocket costs for healthcare.
Family: you + spouse + children Classic - $331.00 premium No change from what you re paying today in this plan Health Savings - $238.40 premium $92.60 less @ month, $1,111.20 less @ year Would it be a financial hardship to pay all your medical expenses (including full cost rx) until you meet $5400 family deductible? Premier $600.64 premium $269.64 more @ month, $3,235.68 more @ year Do the better benefits (meaning lower costs for healthcare) make the higher premiums worth it?
Employee + Spouse coverage Classic - $237.50 premium Health Savings - $169.98 premium $67.52 less @ month, $810.24 less @ year Would it be a financial hardship to pay all your medical expenses (including full cost rx) until you meet $5400 family deductible? Premier $455.44 premium $217.94 more @ month, $2,615.28 more @ year
Employee + Child(ren) coverage Classic - $195.50 premium Health Savings - $140.34 premium $55.16 less @ month, $661.92 less @ year Would it be a financial hardship to pay all your medical expenses (including full cost rx) until you meet $5400 family deductible? Premier $347.90 premium $152.40 more @ month, $1,828.80 more @ year
FSA or HSA for healthcare expenses? Flexible Spending Account Not tied to our medical plan although you cannot be enrolled in UA Health Savings Plan or any other high deductible plan $2600 limit Use it or lose it $500 rollover Debit card, account set up at UMR Health Savings Account Only if you enroll in Health Savings Plan (HSA must be paired with a qualified high deductible plan, IRS reg) $3450 single, $6900 family limit No use it or lose it Debit card, account set up at Optum Bank
More about an HSA It s similar to a checking account. Once money is deposited, it s available for you to spend. You spend it on exactly the same things as an FSA: medical, dental and vision expenses Money you put in through payroll deduction is pre-tax, just like an FSA You are held responsible by the IRS for spending HSA funds only for qualified medical expenses, else subject to taxes + 20% penalty Only people enrolled in qualifying HDHPs are eligible to open and contribute to HSAs.
Set up pretax payroll deduction You can change amount at any time At least put your premium savings here Or fully fund up to the IRS annual limit of $3450/$6900 (limit includes University s contributions) University will contribute $420 single, $840 family Plus extra $90 if you completed wellness ½ will be deposited in January ½ in September How to fund your HSA University contributions not guaranteed in future years You or others can make deposits with after-tax dollars, and may claim tax savings when you file your tax returns Optum Bank monitors the limit
The Health Savings Plan pros and cons + Lower premiums + People who rarely use their health benefits may save money + If you are not on expensive medications, your monthly bills may be lower + Out-of-pocket expenses are not the market rate, but the negotiated rate between the healthcare provider and the insurance company + You can open an HSA, which never expires, to help cover out-of-pocket expenses - People managing chronic illnesses find that their out-ofpocket expenses are high - Prescriptions, office visits, and diagnostic tests are completely out-of-pocket until you reach your deductible - If you need surgery, you will need to hit your deductible before the insurance company will pay anything Learn more by participating in webinar or visiting our website.
The Health Savings Plan might be right for you if You re healthy and rarely get sick or injured You don t need to go to a doctor for more than routine screenings You re not on expensive medications You can afford to pay your $2700 ($5400 family) deductible upfront if an unexpected medical expense comes up You have the means to make significant contributions to an HSA each paycheck; you are committed to funding your HSA You are healthy and are interested in using an HSA as a way to save or invest money
The Premier or Classic Plan might be right for you if You are pregnant, planning to become pregnant, or have small children You have a chronic condition or need to see a doctor frequently You re considering a reparative surgery, such as a knee or hip replacement You take several prescription medications, or even just one expensive drug You or your children play sports, especially those with high risk of injury You want the security of first dollar coverage You don t have the budget to pay the full price of a medical bill or prescription out-of-pocket, or you re willing to pay more each month (premium) for the peace of mind in knowing about how much you ll pay when you visit the doctor
Sorry, no crystal ball Your Decision Your decision will be highly individual, a financial choice based on you and your family s health care needs But keep in mind that getting the medical care you need when you need it, including free preventive care, is best for your health and your bank account You can make a worse case scenario plan if you are worried about how much each insurance plan could ultimately cost you. The numbers you should add up are the annual cost of premiums, the deductible, and the maximum out of pocket expense for each plan. This will help you see how much you will ultimately spend and which plan is the most affordable.
Let s Compare Cost A single employee has met the deductible for the plan. What would be the total cost for s/he with premiums and deductibles and out of pocket maximum met per plan if s/he received their care in-network (not UAMS SmartCare): Classic Premier Health Savings Total spent in Premiums $1,254 $2,076 $891 Deductible met $1,250 $150 $2,700 Total spent in Premiums + Deductible $2,504 $2,226 $3,591 Total spent in Premiums + Out of Pocket Max Total spent in Premiums + Out of Pocket Max (with wellness incentive) $6,504 + 1600 rx = $8,104 $5,104 + 1600 rx = $6,704 $5,076 + 1600 rx = $6,676 $7,541 * $4,576 + 1600 rx = $6,176 $7,541 * *RX OOP max included. University contributes $420 to HSA for family plan, plus additional $90 if completed wellness, which can be used to pay healthcare costs.
Let s Compare Cost A family has met the deductible for the plan. What would be the total cost for a family with premiums and deductibles and out of pocket maximum met per plan if they received their care in-network (not UAMS SmartCare). Classic Premier Health Savings Total Spent in Premiums $3,972 $7,208 $2,861 Deductible met (family) $2,500 $1,300 $5,400 Total spent in Premiums + Deductible $6,472 $8,508 $8,261 Total spent in Premiums + Out of Pocket Max Total spent in Premiums + Out of Pocket Max (with wellness incentive) $14,472 + 3200 rx = $17,672 $11,672 + 3200 rx = $14,872 $13,208 + 3200 rx = $16,408 $12,208 + 3200 rx = $15,408 *RX OOP max included. University contributes $840 to HSA for family plan, plus additional $90 if completed wellness, which can be used to pay healthcare costs. $16,161 * $16,161 *
Questions? 4:30 p.m., Thursday, 11-30-2017 is the deadline for our office to receive your open enrollment forms/ess elections.