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Employee Benefits Insurance Plans

Employee Benefits Insurance Plans. Insert your Company’s Logo Here. Presented by: O’Neill Benefits Group Brokerage. Plan Administrator. Medical Insurance UNITED HEALTHCARE Open Enrollment May 1, 2006. Dependent Enrollment.

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Employee Benefits Insurance Plans

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  1. Employee Benefits Insurance Plans Insert your Company’s Logo Here Presented by: O’Neill Benefits Group Brokerage

  2. Plan Administrator • Medical Insurance • UNITED HEALTHCARE • Open Enrollment May 1, 2006

  3. Dependent Enrollment • Effective May 1, 2006, employees may enroll dependent children through the age of 25 with no student status verification • Dependent children are eligible until the end of the month of their 25th birthday • Dependent children must be unmarried and financially dependent or living at home

  4. OPEN ENROLLMENT • If you had waived coverage for yourself or your dependents, you may enroll now with no medical screening. • You may switch your current plan selection with United Health Care – you may enroll in the HSA plan or stay in the current plan USJ.

  5. CRISIS? Principal Premium 1998 39 employees: $180,839 UHC USJ Premium 2006 31 employees: $366,001

  6. What is a dual option? You select one plan between two different medical it plan option. • The employer pays for 100% of the HD-D (base plan) for single coverage and dependent coverage (spouse and/or children). The employer will also contribute $750 of the plan deductible to the employee’s Health Savings Account for the base plan. • If the employee selects the US-J (buy-up) plan, the employee must contribute towards the cost for single and dependent coverage.

  7. What are the costs to the employee for the Buy Up plan? Plan US-J ($1,500/$4,500 deductible) BUY-UP Plan Employee only: $56.06 / month Employee + spouse: $111.81 / month Employee + child/children: $94.93 / month Employee + family: $158.68/month

  8. Deductible Carry-forward • Deductibles incurred in calendar year 2006 will be credited to either plan you enroll in.

  9. Plan HD-D (HSA) Benefit Summary

  10. Plan US-J (Buy up )Benefit Summary

  11. United Healthcare Websites • http://www.uhc.com/ • www.myuhc.com • www.unitedhealthwellness.com

  12. Distinguishing Features: • Balanced approach to total well-being (more than physical health) • “Wellness-only” focus for distinct appeal when compared to most health-related Web sites

  13. Distinguishing Features: • Balanced approach to total well-being (more than physical health) • “Wellness-only” focus for distinct appeal when compared to most health-related Web sites

  14. The Uncovered “Spend” You have purchasing power for services not covered by a insurance plan – which reduce your overall out of pocket expenses. • Savings on out of pocket expenses for services traditionally not covered by health insurance • Web-enabled consumer information and decision-making tools • Concierge services • No referrals or claim forms • Dental • Vision • Long-Term Care • Alternative Care • Wellness • Infertility • Hearing The average family spends roughly $675 a year on non-covered health care services.

  15. 1. Search for provider by name, location, or specialty 2. Compare provider rates 3. View provider details and make selection 4. Confirm rate & print confirmation HealthAllies Easy to Use

  16. Distinguishing Features: • Balanced approach to total well-being (more than physical health) • “Wellness-only” focus for distinct appeal when compared to most health-related Web sites

  17. HSA Overview • HSA is money put in an account owned by an individual to pay for future medical expenses • Must be used in conjunction with “High Deductible Health Plan” (HDHP) • Insurance that does not cover first dollar medical expenses (except for prevention)

  18. Advantages of HSAs • HSA accounts encourage savings for future medical expenses • When employer-sponsored coverage is lost during periods of unemployment • COBRA continuation coverage • other coverage • Insurance coverage or medical expenses after retirement (before Medicare eligibility) • Long-term care expenses • Out-of-pocket expenses for Medicare • Non-covered services under future coverage

  19. Advantages of HSAs • Accounts are owned by the individual (not an employer) • Individual decides: • How much to contribute • How much to use for medical expenses • Which medical expenses to pay from the account • Whether to pay for medical expenses from the account or save the account for future use • Which company will hold the account • What type of investments to grow account

  20. Advantages of HSAs • Accounts are completely portable, regardless of: • Whether the individual is employed or not • Which employer the individual works for • Which state an individuals moves to • Age or marital status changes • Future medical coverage

  21. Advantages of HSAs • No “use it or lose it rules” like Flexible Spending Arrangements (FSAs) • Unspent balances in accounts remain in the account and can grow through investment earnings • Encourages account holders to spend their funds more wisely on their medical care • Encourages account holders to shop around for the best value for the health care dollars

  22. Advantages of HSAs • Accounts can grow through investment earnings • Many different investment options could be pursued • Individual chooses investment option that best meets their needs • HDHP premiums are cheaper than health insurance with traditional deductibles

  23. Who Is Eligible for HSAs? • Any individual that: • Is covered by a HDHP • Is not covered by other health insurance • does not apply to specific injury insurance and accident, disability, dental care, vision care, long-term care • Is not eligible for Medicare • Can’t be claimed as a dependent on someone else’s tax return

  24. What Is a “High Deductible Health Plan” (HDHP)? • Health insurance plan with minimum deductible of: • $1,000 (self-only coverage) • $2,000 (family coverage) • Annual out-of-pocket (including deductibles and co-pays) does not exceed: • $5,100 (self-only coverage) • $10,200 (family coverage) • HDHPs can have: • no deductible for preventive care • higher out-of-pocket (copays & coinsurance) for non-network services

  25. HSA Contribution Rules • Contribution to HSA can be made by either the employer or the individual, or both • If made by the individual, it is an “above-the-line” deduction • If made by the employer, it is not taxable to the employee (excluded from income) • Can be made by others on behalf of individual and deducted by the individual • All contributions are aggregated

  26. Employer Contribution The W.W. Reynolds Companies is making a one time contribution of $750 in a lump sum either to: Employee’s HSA Trust Account OR as ordinary income if Plan US J is selected

  27. Employee Contribution Employees of The W.W. Reynolds Companies can contribute up to the individual or family maximum by depositing funds directly into their Trust account. Tax forms now have a line item for HSA contributions and are deducted before tax is calculated.

  28. HSA Contribution Rules • Maximum amount that can be contributed to an HSA (and deducted): • Amount of High Deductible for 12 month plans HOWEVER • For 2006 the amount is pro-rated for the year • Individual: Maximum contribution is: $1,333.33 • Family: Maximum contribution is: $2666.66

  29. HSA Contribution Rules • For individuals age 55 and older, additional “catch-up” contributions to HSA allowed • 2005 - $600 • 2006 - $700 • 2007 - $800 • 2008 - $900 • 2009 and after - $1,000 • Contributions must stop once an individual is eligible for Medicare

  30. HSA Distributions • HSA funds can be used to pay for eligible expenses incurred • ON OR AFTER the date the Trust account is established.

  31. HSA Distributions • Distributions are tax-free if taken for “qualified medical expenses” • Now includes over-the-counter drugs • Can ALSO pay for other health insurance: • COBRA coverage • Qualified long-term care insurance • Health plan coverage while receiving unemployment compensation • For individuals eligible for Medicare: • Medicare (Part A, Part B, Medicare+Choice) • employee share of premiums for employer-based coverage • Cannot pay Medigap premiums

  32. HSA Distributions • Distributions are tax-free if taken for: • person covered by the high deductible • spouse of the individual • any dependent of the individual • Spouse and dependents don’t need to be covered by the HDHP • If not used for qualified medical expenses, then amount is included in income • 10% additional tax if taken for non-medical expenses, except when taken after: • Individual dies or becomes disabled • Individual is eligible for Medicare

  33. HSA Distributions • HSA custodian (Trust account) must report all distributions – but is not required to check them for eligibility • Should the HSA participant keep receipts? • YES! Need to prove that deductible was met • Not all medical expenses paid out of the HSA have to be charged against the deductible (e.g. prescription sunglasses)

  34. Preventive Covered at 100% on HAS plan No co-pay or deductible • Preventive Definition • Periodic Health Evaluations • Well baby and/or well-child • Immunization

  35. Funding (Deposit) Process • Fund HSA bank account via payroll deductions, or direct deposit. • Obtain health services that are subject to the deductible after using myuhc.com to determine lowest cost, best treatment options, etc. • Receive EOB from claim system, or view claim on-line at myuhc.com stating consumer liability. • Use debit card or check to pay the physician directly from the HSA bank account or use you disposable income to save today for tomorrow’s expenses • Receive monthly bank statement detailing deposits and withdrawals or view on-line on bank web-site. • End of the year consumer will receive tax forms (direct deposits outside of payroll) and will see interest, but they do not have to pay taxes on that interest • Enjoy savings and establish a more secure retirement.

  36. Identification and Debit Cards • Healthcare Account Card (ID or Eligibility card) • Can be used at any Mastercard terminal • Used to obtain eligibility and copay information within 10 seconds • Ability to send optional fax back with enhanced information • HIPAA compliant 270/271 transactions • Health Savings Account Debit Card • Effective 1/1/05 • Works like any checking account debit card - use at ATM or any merchant (part of the Cirrus network)

  37. Banking Services • Banking services are through Exante Bank, a UnitedHealth Group owned affiliate • Account is interest bearing • Access to account is via a Mastercard debit card or checkbook • On-line bill pay • Bank arrangement: • $5 per account for set up • $3 PEPM Banking Fees charged to employee bank account • Other miscellaneous consumer banking fees apply

  38. O’Neill Benefits Group Brokerage • Broker • Pat O’Neill • Customer Service • (303) 443-9929

  39. Login Username: login Password: password

  40. 2 tool bars to navigate your plan

  41. NEW WEBSITE FOR ALL PLAN DOCUMENTS- FORMS- LINKS www.obgb.com

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