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Open Enrollment Presentation . January 2010. Agenda. Changes to BigBand’s Benefit Programs Overview of Plans What You Need to Do Important Paperwork Life Changes . Overview of Benefits Programs. The following slides are condensed overview of BigBand’s benefits
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Open Enrollment Presentation January 2010
Agenda • Changes to BigBand’s Benefit Programs • Overview of Plans • What You Need to Do • Important Paperwork • Life Changes
Overview of Benefits Programs • The following slides are condensed overview of BigBand’s benefits • For details, please consult providers’ plan documents
Filice Insurance Services/Resources • Dedicated Account Management team • Eric Pogue – 925-299-7212; epogue@filice.com • Chris Kelly – 925-299-7216; ckelly@filice.com • Alaina Kelly – 925-299-7213; akelly@filice.com • Assistance with claims, eligibility, forms, carrier issues, etc. • Customized benefits website: www.filice.com/benefits/bigband
Blue Shield HMO Plan Design • Blue Shield HMO • Deductible (facility deductible) $1,500 per member • Co-payment maximum $2,000 per member • Primary Care Physician Visits $15 (deductible does not apply) • Routine physicals / well-child $15 (deductible does not apply) • No cost for vision / hearing screenings or medically necessary immunizations • Emergency $100 (Waived, if admitted) • Outpatient Surgery Facility deductible, then $100 / surgery • Hospitalization Facility deductible, then 10% • Prescription (Mail Order = 2 times these co-pays for up to a 90-day supply) • Generic $10 (deductible does not apply) • Brand Formulary *** $25 (deductible does not apply) • Non-Formulary *** $40 (deductible does not apply) *** $250 Calenday-year Brand-name Drug Deductible
What is a deductible reimbursement plan? (Commonly referred to as a Health Reimbursement Account) • A company-sponsored deductible reimbursement plan. • Reimburses employees and their dependents for any allowable medical expenses under the company sponsored plan • Set up in accordance with IRS Code Section 105: medical reimbursements to employees are not considered taxable income to the employees or their dependents.
Kaiser HMO (HRA) Plan Design • Kaiser HMO(HRA) • Deductible $2,000 self only & one member in a family of 2, or more • Deducbile $4,000 for an entire family of 2, or more members • Co-payment maximum $4,000 self only & one member in a family of 2, or more • Co-payment maximum $8,000 for an entire family of 2, or more members • Primary Care Physician Visits $20 (after deductible) • Routine physicals $20 (deductible does not apply) • Well-child $10 (deductible does not apply) • Emergency 20% (after deductible) • Outpatient Surgery 20% (after deductible) • Hospitalization 20% (after deductible) • Prescription (Mail Order varies) • Generic $10 (deductible does not apply) • Brand Formulary $30 (deductible does not apply)
Blue Shield PPO Plan Design (HRA) • Blue Shield (Shield Spectrum PPO Savings Plus 2250 Deductible Plan • Deductible: $2,250 / individual - $4,500 / family (in or out-of-network combined) • Out-of-Pocket Max. $3,000 / individual - $5,500 / family (in or out-of-network combined) • Co-Insurance 80% in-network – 50% out-of-network • Office Visit 20% in-network (after deductible) – 50% out (after deductible) • Preventive / well-child No charge (deductible does not apply) – Not covered out-of-network • Other covered non-preventive services subject to the deductible • Emergency 20% (after deductible) – in or out-of-network • Outpatient Surgery 20% in-network (after deductible) – 20% out (after deductible) • Hospitalization 20% in-network (after deductible) – 50% of $600 + excess • Prescription (Mail Order = 2 times these co-pays for up to a 90-day supply) • Generic $10 (you must meet your deductible before co-pays begin) • Brand Formulary $25 (you must meet your deductible before co-pays begin) • Non-Formulary $40 (you must meet your deductible before co-pays begin)
The BigBand Health Reimbursement Arrangement and the Comparative Costs SINGLE EMPLOYEE • Monthly premium costs: • $42.10 for the Blue Shield HMO • $60.11 for Kaiser (HRA) • $79.89 for the Blue Shield PPO (HRA) • Annual deductible exposure: • $1,500 facility deductible for Blue Shield HMO • $1,000 for Kaiser HRA (BigBand will fund up to the first $1,000 via the HRA) • $1,000 for Blue Shield PPO (BigBand will fund up to the first $1,250 via the HRA) • Office Visits • $15 (no deductible) for the Blue Shield HMO • 20% for Blue Shield PPO (after deductible) BigBand funds $1,250 via HRA • $20 for Kaiser (after deductible) BigBand funds $1,000 via HRA • Inpatient care exposure: • $1,500 for the HMO • $1,000 for Kaiser ($2,000 - $1,000 HRA funding) • $1,750 for Blue Shield ($3,000 - $1,250 HRA funding)
The BigBand Health Reimbursement Arrangement and the Comparative Costs (for a family) FAMILY • Monthly premium costs: • $201.17 for Blue Shield HMO • $180.32 for Kaiser (HRA) • $228.84 for Blue Shield PPO (HRA) • Annual deductible exposure: • $1,500 facility deductible (per member) for Blue Shield HMO • $2,000 for Kaiser HRA (BigBand will fund up to the first $2,000 via the HRA) • $2,000 for Blue Shield PPO (BigBand will fund up to the first $2,500 via the HRA) • Office Visits • $15 (no deductible) for the Blue Shield HMO • 20% for Blue Shield PPO (after deductible) BigBand funds $2,500 via HRA • $20 for Kaiser (after deductible) BigBand funds $2,000 via HRA • Inpatient care exposure: • $1,500 for the HMO • $2,000 for Kaiser ($4,000 - $2,000 HRA funding) • $3,000 for Blue Shield ($5,500 - $2,500 HRA funding)
Dental Plan Design • Delta Dental PPO • Questions ? Call 1-800-765-6003 • Provider Directory = www.deltadentalins.com • Services • Deductible * $50 / individual - $150 / family • Annual Maximum $1,500 • Co-Insurance InOut (Subject to Usual, Customary & Reasonable) • Preventive - 100% 100% • Basic - 90% 80% • Major - 60% 50% • Orthodontics (child only) 50% 50% ($1,000 Lifetime Maximum) • Pre-determination Review (Recommended for services > $300)
Dental Plan Design (Buy-up Option) • Delta Dental PPO • Questions ? Call 1-800-765-6003 • Provider Directory = www.deltadentalins.com • Services • Deductible * $50 / individual - $150 / family • Annual Maximum $2,000 in-network / $1,500 out-of-network • Co-Insurance InOut (Subject to Usual, Customary & Reasonable) • Preventive - 100% 100% • Basic - 90% 80% • Major - 60% 50% • Orthodontics (adult & child) 50% 50% ($1,500 Lifetime In & $1,000 Lifetime Out)) • Pre-determination Review (Recommended for services > $300)
Vision Plan Design • Vision Service Plan • Questions ? Call 1-800-877-7195 • Provider Directory = www.vsp.com • Services • Co-pay $25 (does not apply to contacts) • Exams: Once every 12 months • Lenses: Once every 12 months • Frames ($120 allowance) Once every 24 months • Contact Lenses ($120 allowance) Once every 12 months *** Laser Vision Correction Discounts *** * See fee schedule for out-of-network benefits
Life/AD&D and Disability • Sun Life • Questions ? Call 1-800-247-6875 • Website = www.sunlife-usa.com • Life Insurance • 1.5 times basic annual salary to a maximum of $375,000 • Voluntary Life up to 5 times salary (maximum benefit = $500,000) • Disability • STD = 66 2/3% of weekly earnings to a maximum of $2,309 per week • 7-day elimination period • LTD = 66 2/3% of monthly pay to maximum monthly benefit of $10,000 • 90-day elimination period
Employee Assistance Program • Employee Assistance Program • Need Assistance ? Call 1-877-327-4753 • Website = www.guidanceresources.com • Company ID # ZB3042Q • Assistance with the following: • Confidential Counseling on Personal Issues • Legal Information, Resources and Consultation • Financial Information, Resources and Tools • Information, Referrals and Resources for Work-Life Needs • Online Information, Tools and Services • The Importance of Having a Will
Assist America Travel Assistance) • Provides medical assistance when traveling more than 100 miles from home • Need Assistance ? Call 1-800-872-1414 in the United States • Need Assistance ? Call 301-656-4152 outside of the United States • Assistance with the following: • Medical Consultation and Evaluation • Hospital Admission Guarantee • Emergency Evacuation • Critical Care Monitoring • Medically Supervised Repatriation • Prescription Assistance • Care for minor children • Legal and Interpreter Referrals • Return Mortal Remains
Pension Dynamics (Flexible Spending) • Questions ? Call 800-888-1998 • Website = www.pensiondynamics.com • Medical Expenses • Medical Reimbursement Limit = $3,000 • Eligible Expenses • Non-Eligible Expenses • Over-the-Counter Reimbursements • Dependent Care • $5,000 limit • Educational versus Custodial • Day Camp versus Overnight Camp
Voluntary Pet Insurance • VPI Pet Insurance • Nation’s largest & oldest provider • Plan is completely portable • Discounts (5% core policies / 10% for 2-3 pets) • Low deductible of $50 • Vaccination & Routine Care coverage available • Easy Enrollment • www.petinsurance.com/nbg • 866-332-7620 • Customer Care • my.petinsurance.com • 800-USA-PETS
Pre-Paid Legal • Pre-Paid Legal plan • Telephone Conversations (unlimited) • Letters/Phone Calls on your behalf (one per subject) • Unlimited Document Review (10-pages per document) • Identity Theft Shield (Kroll Background America) • Detailed Credit Report (Experian / FICO Score / Analysis • Continuous Credit Monitoring (Daily) • Safeguard for Minors • Children under age 18 • Continuous Credit Monitoring
Liberty Mutual Auto & Home Voluntary Benefits • Car Insurance • Liability • Medical Payments / Personal Injury • Uninsured / Underinsured Motorists • Collision • Comprehensive • Mechanical Parts Replacement • Car Windshield Repairs • New Car Replacement • Homeowners Insurance • Your Home • Your Possessions • Your Liability
Maximizing Health Benefits • Utilize benefits that provide for preventive coverage • Semi-annual dental cleanings and exams • Annual eye exam • Be a savvy consumer – can save you $$$ • Choose plans that fit your situation best • Familiarize yourself with spouse’s/partner’s plan • Question doctor regarding procedures and necessity, generic prescriptions, billing rates, joining carrier’s in-network listing, referrals to in-network specialists
Open Enrollment - BeneTrac • BeneTrac: We will notify you when you can access the system for enrollment. • BCBS MA / Delta Dental & VSP – If you are enrolled and you do not want to make any changes, you do not need to do anything but you should review your BeneTrac account and click “finalize”. • Group Life/AD&D and Disability - You are automatically enrolled for the group benefits. • Voluntary Life – If electing to increase your Voluntary Life, or enroll for the first time, please complete an application. If you are adding to existing coverage, or a new enrollment exceeding the Guarantee Issue amounts, you will also need to complete an Evidence of Insurability Form. • Flexible Spending Accounts for 2010 – If you are enrolling, you must re-elect your contributions in BeneTrac, even if you were enrolled last year.
Life Changes Must be done within 31 days from Qualifying Event • Birth or adoption of a child or dependent change • Marriage, divorce, or domestic partner • Child(ren) – Full-time students between the ages of 19 and 25 • Spouse’s change of employment • Temporary assignment outside of coverage area