Your Benefits Your Choice! Active Employees It is once again time to make some important decisions regarding your insurance needs. is holding open enrollment from November 1 to November 20, 2015. We encourage you to take time to consider your current benefit elections and the coverage you will need in 2016. The decisions you make during this next enrollment will be in place for the entire year (January 1 through December 31), unless you experience a qualifying event, such as marriage, birth/adoption of a child, change in employment of spouse, etc. Health care costs continue to rise. Medical and prescription drug costs are increasing in the 7 8 percent range each year. New lifesaving prescription drug treatments are being offered which cost as much as $70,000 to $100,000 per treatment. After the passage of the Affordable Care Act (ACA), prevention benefits have been enhanced, eligibility benefits expanded, and new fees and taxes required. For the past three years, the University has navigated the rising costs without significant plan design changes and employee contribution increases. We considered multiple alternatives for the coming year to address health care cost increases and reviewed several benchmarking sources to ensure our benefits package remains competitive. Consistent with previous years, our medical plans were developed with input from our Medical Ad Hoc Committee, which includes representatives from the Staff Advisory Committee, Faculty Senate, SLUCare, the School of Medicine, and Human Resources, with final approval by the President s Coordinating Council. In 2016, there will be no plan design changes to the PPO or QHDHP plans. We are, however, making a change to eligibility rules. Please see the box to the right for additional information. In addition, the University will maintain the 75 percent/25 percent cost share between the University and its employees. This means when looking at the total cost of our medical and prescription drug program, the University pays 75 percent of the total cost. The total cost of the plan for 2016 is estimated to be $40 million. Employee contributions, which are made on a pre-tax basis, make up the remaining 25 percent. As a result of increased claim costs, there will be an increase in employee contributions for 2016. The employee contributions are outlined on page 4 of this letter. We are pleased to let you know we are increasing the salary threshold for the medical subsidy from $33,000 to $37,000 effective January 1, 2016. This means for employees earning $37,000 or less, the University will pay the full medical premium if you elect the Plus Plan, Employee Only coverage, and participate in the Vitality wellness program. Further, the subsidy for the Employee Only level will also apply to the Employee + Spouse, Employee + Child(ren), and Family tiers. 2016 ENROLLMENT Working Spouse Rule Effective January 1, 2016, if your spouse has access to health insurance through their employer, they are no longer eligible to be covered under Saint Louis University s health insurance plan. Spouses are still eligible for coverage on SLU s plan if they: Are not employed Are not eligible for coverage through their employer Are not offered coverage through their employer Are on Medicare and do not have access to an employer program This change is consistent with the way many employers are responding to rising health care costs. Employees who wish to keep their spouse on their SLU insurance will be required to complete and submit a Spousal Health care Affidavit to the SLU Benefits Office. Additional information and the affidavit for completion can be found http://www. slu.edu/human-resources-home/openenrollment-2016. Open Enrollment Meetings Date Time Location Wednesday, October 28 11:00 a.m. to 12:00 p.m. Learning Resource Center (LRC), Auditorium C Wednesday, November 4 11:00 a.m. to 12:00 p.m. Busch Student Center (BSC), Room 253 A and D Thursday, November 12 11:30 a.m. to 12:30 p.m. LRC, Auditorium B Monday, November 16 11:30 a.m. to 12:30 p.m. BSC, Room 253 A and D Please read this newsletter to find out more about your benefits program.
2 Medical/Prescription Drug Benefits Medical benefits will remain with UnitedHealth care (UHC) and prescription drug benefits will remain with Express Scripts. You will continue to have the option between two plans the Plus Plan and the Qualified High Deductible Health Plan (QHDHP). Both plans utilize the UHC Choice Plus network. As stated earlier, there will be no plan design changes to either plan for 2016. Copays, coinsurance, and deductibles will remain the same. In addition, SLU continues to maintain and implement pharmacy initiatives aimed at controlling our program costs and promoting internal efficiencies. Plus Plan The Plus Plan is a traditional PPO plan. When you visit a SLUCare provider, you will be charged an office visit copay. The cost for an office visit with all other network providers will be subject to deductible and coinsurance. The savings of choosing SLUCare can be substantial for many employees. There are also copays for prescription drugs. Routine preventive care is covered at 100 percent, no cost to the member. QHDHP Plan The primary difference between the Plus Plan and the QHDHP is the QHDHP has lower payroll deductions, but higher deductibles. Routine preventive care, as well as certain preventive medications, are covered by the plan at 100 percent. An important benefit of participation in the QHDHP is the ability to contribute to a Health Savings Account (HSA). An HSA allows you to save money to pay for medical expenses on a pre-tax basis. Unlike the flexible spending account, there is no time limit for you to use the funds, and if you leave the University or retire, the funds remain yours. In addition, to help you develop a nest egg to cover your health care expenses, the University will continue to contribute $250 into your HSA if you elect individual coverage and $500 for those enrolled with dependent coverage so long as you establish your HSA through Optum Bank by November 20. Wellness Plan Because believes in the power of good health, our partnership with Vitality will continue in 2016. If you are engaged in the program, we will continue to reward your healthy behavior through the medical premium wellness discount. The wellness discount is $50 for employee only coverage and an additional $25 for those with a covered spouse. To receive the wellness discount, you must complete both the Vitality Check and Vitality Health Review (VHR) by November 20, 2015. If covering your eligible spouse, your spouse must also complete both requirements for both employee and spouse to qualify for the discount. The Vitality Check is the biometric screening which includes screenings for height, weight, blood pressure, fasting glucose, and cholesterol. The Vitality check is also free for covered employees and spouses. The VHR is the online health assessment which needs to be completed by employees through www.powerofvitality.com. Dental Dental benefits will remain with Delta Dental. The benefits and rates will remain unchanged for 2016. You will continue to have the option between two plans the Flex Plan and the Basic Plus Plan. Vision Vision benefits will remain with VSP. The benefits and rates will remain unchanged for 2016. Accident Accident benefits will remain with Voya. The benefits and rates will remain unchanged for 2016. We continue to sponsor programs through UHC which help pre-diabetics and diabetics focus on prevention, control, and ongoing management. Take advantage of these UHC outreach programs and utilize the coaches and resources available to you. More information can be found at www.uhctogether.com/slu. Human Resources has partnered with Family and Community Medicine to increase access and availability of primary care services at three locations across the region. Having a relationship with a primary care team is recommended to maintain good health, coordinate chronic care, choose specialists when needed and prevent unnecessary use of urgent care and emergency rooms. More information about Medical Home can be found at http://www.slu.edu/family-and-community-medicine-home/ mycare-medical-home.
3 Tax Favored Health Accounts Both the Health Flexible Spending Account (FSA) and the Health Savings Account (HSA) are offered in 2016. Below is a quick comparison between the two accounts. For additional information on the HSA, please see the supplemental open enrollment communication piece found on the open enrollment page. While not outlined below, the Dependent Care FSA will continue to be offered through ConnectYourCare with no changes to the contribution limit of $5,000. Please note the use it or lose it rule applies to both the Health FSA and the Dependent Care FSA. This means money set aside in the FSA accounts must be spent by the end of the plan year. Receipts for eligible expenses must be submitted to ConnectYourCare no later than March 31, 2016. FSA If you enroll in the Plus Plan (or no medical plan at SLU), you are eligible to contribute to the Health FSA The Health FSA is administered by ConnectYourCare You can contribute up to $2,550 pretax per calendar year (maximum set by PPACA) SLU does not contribute to the Health FSA Please make your election for 2016; current elections will not carry forward! If you leave SLU, you cannot take this account with you The money must be used during the plan year use it or lose it applies (exception for the grace period) You can use this money to pay for eligible medical, Rx, dental, and vision expenses throughout the year HSA If you enroll in the QHDHP and meet all the eligibility requirements set by the IRS, you are eligible to contribute to the HSA The HSA is administered by Optum Bank You may contribute up to $3,350 for single coverage and $6,750 for family coverage pre-tax in 2016 SLU will contribute the seed money into your Optum Bank account: Single: $250 Family: $500 An election is required for 2016; current elections will not carry forward! If you leave SLU, you take the account with you Unused funds can be rolled over to next year no use it or lose it rule You can use this money to pay for eligible medical, Rx, dental, and vision expenses throughout the year
4 Medical/Prescription Drug 2016 Pre-Tax Plan Payroll Deductions Coverage Type UHC Plus Plan Monthly Bi-Weekly Premium With Wellness Discount Premium With Wellness Discount Employee (Ee) $153.26 $103.26 $70.74 $47.66 Ee/spouse $418.49 $343.49 $193.15 $158.53 Ee/child(ren) $360.76 $310.76 $166.50 $143.43 Family $565.68 $490.68 $261.08 $226.47 UHC Qualified High Deductible Health Plan Employee (Ee) $82.63 $32.63 $38.14 $15.06 Ee/spouse $270.14 $195.14 $124.68 $90.06 Ee/child(ren) $226.56 $176.56 $104.57 $81.49 Family $353.78 $278.78 $163.28 $128.67 UHC Plus Plan Employees earning up to $37,000 Employee (Ee) $50.00 $0.00 $23.08 $0.00 Ee/spouse $315.23 $240.23 $145.49 $110.88 Ee/child(ren) $257.50 $207.50 $118.85 $95.77 Family $462.42 $387.42 $213.42 $178.81 Dental 2016 Pre-Tax Plan Payroll Deductions No Changes Coverage Type Monthly Bi-Weekly Flex Option New Basic Plus Option Flex Option Basic Plus Option Employee (Ee) $36.01 $21.07 $16.62 $9.72 Ee + 1 $70.49 $40.52 $32.53 $18.70 Family $120.69 $72.60 $55.70 $33.51 Vision 2016 Pre-Tax Plan Payroll Deductions No Changes Coverage Type Monthly Bi-Weekly Employee (Ee) $7.02 $3.24 Ee/spouse $12.76 $5.89 Ee/child(ren) $13.38 $6.18 Family $20.66 $9.54 Accident 2016 Plan Payroll Deductions No Changes Coverage Type Monthly Bi-Weekly Employee (Ee) $24.74 $11.42 Ee/spouse $41.90 $19.34 Ee/child(ren) $39.62 $18.29 Family $56.78 $26.21
5 Medical/Prescription Drug Plan Comparison Plus Plan QHDHP Plan SLUCare UHC In-Network Out-of-Network SLUCare UHC In-Network Out-of-Network Deductible Non-Embedded: Individual $0 $500 $750 $1,500 $1,500 $3,000 Family $0 $1,000 $1,500 $3,000 $3,000 $6,000 Coinsurance 0% 10% 40% 0% 10% 40% Out-of-Pocket Maximum (includes deductibles and copays) Non-Embedded: Individual $1,500 $1,500 $4,750 $1,500 $3,000 $6,000 Family $3,000 $3,000 $9,500 $3,000 $6,000 $12,000 Physician Office Visits Primary care $10 copay 10% after ded. 40% after ded. 0% after ded. 10% after ded. 40% after ded. Specialist care $20 copay 10% after ded. 40% after ded. 0% after ded. 10% after ded. 40% after ded. Inpatient Hospital N/A 10% after ded. 40% after ded. N/A 10% after ded. 40% after ded. Emergency Room Urgent Care Center N/A $100 copay $100 copay N/A 10% after ded. 10% after ded. N/A $50 copay 40% after ded. N/A 10% after ded. 40% after ded. Plus Plan QHDHP Plan Retail (34-day supply) Mail Order (90-day supply) Retail (34-day supply) Mail Order (90-day supply) Tier 1 $8 $16 Medical deductible and coinsurance Tier 2 $30 $60 Medical deductible and coinsurance Tier 3 $50 $100 Medical deductible and coinsurance Tier 4 20% to $150 Not covered Medical deductible and coinsurance Select preventive medications Priced according to the tier in which they fall Covered at 100%, no copay or deductible Dental Plan Comparison Schedule of Benefits Flex Option Basic Plus Option Type of Plan Delta Dental PPO Delta Dental PPO Network considerations In-network Out-of-network * In-network Out-of-network * Coinsurance (Plan Pays) Type A: preventive care 100% 100% 100% 50% Type B: basic restorative services 90% 70% 70% 35% Type C: major restorative services 60% 40% 40% 20% Type D: orthodontics 50% 40% 50% 25% Deductible (applies to) B & C Services B & C Services B & C Services B & C Services Per person $50 $50 $25 $25 Per family $150 $150 $75 $75 Benefit Maximums Annual benefit maximum per person $1,500 $1,500 $1,000 $1,000 Lifetime orthodontia benefit maximum $1,000 adult and child (up to age 26) $1,000 adult and child (up to age 26) $1,000 child only (up to age 19) $1,000 child only (up to age 19) * Delta Premier Network or non-participating providers
6 Vision Plan In-Network (Choice Network) Out-of-Network Wellvision exam $10 copay Up to $45 allowance Lenses Single $10 copay Up to $30 allowance Bifocal $10 copay Up to $50 allowance Trifocal $10 copay Up to $65 allowance Frames Contacts Frequency Exam, lenses, contacts Frames Accident Plan $150 allowance for a wide selection of frames; $170 allowance for featured frame brands; 20% on the amount over your balance $150 allowance for contacts; including the contacts lens exam (fitting and evaluation) Every calendar year Every other calendar year The below is a high level overview of the plan design. Additional benefits are available under the policy. Accident Hospital Care Service Benefit Amount Surgery (open abdominal, thoracic) $1,200 Hospital confinement Follow-Up Care $250/day up to 365 days Medical equipment $120 Physical therapy Prosthetic device Emergency Care $30/treatment (six max) $600 (one)/$1,200 (two or more) Ground ambulance transport $120 Emergency room treatment $180 Up to $70 allowance Up to $105 allowance Common Injuries Dislocations Closed Reduction/Open Reduction * Hip joint $2,400/$4,800 Knee $1,200/$2,400 Shoulder $360/$720 Common Injuries Fractures Closed Reduction/Open Reduction Hip $1,800/$3,600 Leg $960/$1,920 Ankle $360/$720 Nose $120/$240 Wellness Benefit ** $100 * Closed Reduction is non-surgical reductions of a completely separated joint. Open Reduction is surgical reduction of a completely separated joint ** The covered employee will receive a single standard annual benefit of $100 for each covered employee and spouse who completes a health screening test. The standard child benefit is 50% of the employee benefit amount, with a maximum of $200 in child benefits payable per calendar year.
Open Enrollment Next Steps Employees with spouses enrolled on the medical plan must either complete the Spousal Health care Affidavit or remove their spouse from medical coverage; this can be done through the Open Enrollment portal on Banner Self-Service Unless you are changing your coverage on Dental, Vision, or Accident, no action is required You must re-enroll in the Health FSA, Dependent Care FSA, and HSA in order to continue the benefit in 2016 All elections must be made through Banner self-service at Banner.SLU.edu between November 1 and November 20, 2015; instructions are available online at http://www.slu.edu/human-resources-home/open-enrollment-2016 Contact List Benefit Administrator Contact Website Medical UnitedHealth care Number on ID card or 866-633-2446 www.myuhc.com Prescription Drug Express Scripts Number on ID card or 800-282-2881 www.express-scripts.com Dental Delta Dental 800-335-8266 www.deltadentalmo.com Vision VSP 800-877-7195 www.vsp.com Accident Voya Financial 877-236-7564 www.voya.com Flexible Spending Account ConnectYourCare 877-292-4040 www.connectyourcare.com Health Savings Account OptumHealth 866-234-8913 option 1 www.optumhealthfinancial.com SLU HR Office 314-977-2595 or benefits@slu.edu hr.slu.edu Notes This Employee Benefits Newsletter is only intended to highlight some of the major benefit provisions of the Company plan and should not be relied upon as a complete detailed representation of the plan. Please refer to the plan s Summary Plan Descriptions for further detail. Should this newsletter differ from the Summary Plan Descriptions, the Summary Plan Descriptions prevail. 2015 Lockton, Inc. All rights reserved. [Rev 10/16/15] EB\STLUN08\EE Comm\Flyers\16EE Letter 782.pdf