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Hebrew Union College 2012 Benefits Presentation. Presented By: Trista Owens, USI Insurance Jeremy Perlin- Director of Human Resources. Meeting Overview. Medical Insurance Base PPO Plan Plan Changes Buy Up PPO Plan Plan Changes Lumenos H.S.A. Plan Certificate of Coverage Changes
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Hebrew Union College 2012 Benefits Presentation Presented By: Trista Owens, USI Insurance Jeremy Perlin- Director of Human Resources
Meeting Overview • Medical Insurance • Base PPO Plan • Plan Changes • Buy Up PPO Plan • Plan Changes • Lumenos H.S.A. Plan • Certificate of Coverage Changes • No Change to Employee Contributions • Dental Insurance • Plan Design • Employee Contributions • New Vision Program • Plan Design • Employee Contributions • Life/AD&D and Long Term Disability- No Changes • Flexible Spending Account- Short Plan Year • Open Enrollment Procedures and Deadlines
Base PPO Plan In Network- Anthem National Blue Card Network • Calendar Year Benefits • Deductible- Single $1,000; Family $2,000 • Coinsurance- 80% Anthem; 20% Member • Out of Pocket Maximum- Single: $3,000; Family $6,000 • Office Visit Primary Care Physician- $25 copay • Office Visit Specialist $50 copay • Emergency Room- $200 copay • Urgent Care- $75 copay • Prescription Drugs- $100 deductible per person per calendar year then $10 Tier 1; $30 Tier 2; $50 Tier 3 • Mail Order- 90 day supply for 2.5 copays • Lifetime Maximum- Unlimited This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
Buy Up PPO Plan In Network- Anthem National Blue Card Network • Calendar Year Benefits • Deductible- None • Coinsurance- 90% Anthem; 10% Member • Out of Pocket Maximum- Single: $1,000; Family $2,000 • Office Visit Primary Care Physician- $20 copay • Office Visit Specialist- $40 copay • Emergency Room- $75 copay • Urgent Care- $35 copay • Prescription Drugs- $10 Tier 1; $30 Tier 2; $50 Tier 3 • Mail Order- 90 day supply for 2.5 copays • Lifetime Maximum- Unlimited This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
Your Lumenos In Network H.S.A.Plan Details At-a-Glance This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.
Lumenos Plan with an HSA With the Lumenos plan, you have a high deductible medical plan coupled with a Health Savings Account (HSA) • You can fund your HSA with pre-tax payroll contributions or post-tax contributions (which are deductible when you file your taxes) • The money in your HSA can be used to pay for your medical care, including prescriptions that go towardsatisfying your deductible • Once you’ve satisfied your deductible the plan’s Traditional Health Coverage prescription copays kicks in.
Using Your Lumenos Plan to Get Care When you visit an in-network doctor: • Show your ID card at the time of service • Typically you pay nothing at the time of service. Your provider will file a claim • You will receive a Claim Recap showing the total cost and the “allowed” cost. Your provider will then bill you for the “allowed” cost of the service(s) • If you have funds in your HSA you can pay your provider using your HSA checkbook or debit card When you visit a doctor that is not in the network: • Show your ID card at the time of service • You may be asked to pay at the time of services. • Use your HSA checkbook or debit card to pay your provider for services (provided you have the funds available) • If your provider does not file a claim on your behalf, you will need to file a claim with Anthem BCBS to ensure expenses get applied towards your out-of-pocket. You can download a claim form at anthem.com
Using Your HSA Plan to Get Care When you visit a pharmacy: • Show your ID card at the pharmacy • Until you have satisfied your annual deductible you will pay the full discounted cost of your prescription drug • You can pay for your prescription at the pharmacy using your HSA debit card or checkbook as long as there are funds available in your HSA account. • After the deductible is met you will pay the applicable copays of $10/$30/$50/25%.
Can I Use My HSA to Pay for Non-Qualified Medical Expenses? Yes, but… • Any amount you spend will be considered taxable income (you will have to pay taxes on the amount used), and you will have to pay a 20% penalty. • Non-qualified expenses will not count toward your deductible. • Once you are 65, you can withdraw the money without penalty, but it will be considered taxable income.
Making Contributions to Your HSA There are several ways you can contribute to your account: • Tax-free through payroll deductions • Post-tax by personal check • When you file your taxes, you can make an adjustment to your gross income to receive the tax benefit • Anyone may contribute to your HSA, provided the total contributions to your HSA do not exceed your maximum allowable annual limit • $3,100 for individual coverage in 2012 ($3,250 in 2013) • $6,250 for family coverage in 2012 ($6,450 in 2013) • You can make catch-up contributions if you are 55 years of age or older ($1,000 for 2012 and 2013)
Am I Eligible for the HSA Plan? The IRS and the U.S. Department of the Treasury have specific rules on who can open an HSA. You can open an HSA if you: • Are enrolled in the Lumenos HSA plan, because it includes an HSA-compatible health plan • Are not enrolled in Medicare or another non-qualified plan • Are not claimed as a dependent on another individual’s tax return • Are not active military • Others – refer to IRS publication 502 Note: You cannot open an HSA if you have coverage under any other health plan that is not an HSA-compatible health plan.
Who is Holding the Funds in My HSA? A qualified financial institution will hold and invest the money. Hebrew Union has Partnered with 5/3. Services provided: • Your debit card and PIN • Your HSA checkbook • FDIC insurance • Monthly account statements • Year-end tax forms *If your employer has selected a financial institution to administer your HSA that is not one of Anthem’s partner banks, or you choose to have your HSA at a different bank, you will not have access to HSA information through Anthem Customer Service or the online health site. Investment rules and fees for your account may also vary.
Anthem Certificate of Coverage Changes Anthem Blue Cross & Blue Shield is moving HUC-JIR to the most recent Certificate of Coverage language. There are some additional changes being made to the plans. The most significant changes are listed below: • Hospice will be covered in full • Home Health Care Visits will increase to 100 per calendar year • Routine Vision Screening will be covered but more limited • In and out of Network Deductibles will accumulate separately
Employee Monthly Contributions Base Plan or HSA Plan The current Salary Based Tier will continue: • Salary under $35,000 is charged 1.75 % for single and 3.25% for Family. • Salary $35,000 to $50,000.00 is charged 2.25% for single and 3.75% for family. • Salary over $50,000 – is charged 2.75% for Single and 4.25% for family. Buy Up Plan • Buy Up Single = % of salary noted above plus an additional $131.04 per month • Buy Up Family = % of salary noted above plus an additional $393.14 per month
Dental Insurance- Guardian The Dental plan design with Guardian will remain the same. In Network- Calendar Year Benefits Deductible: Single $50; Family $150 (waived for Preventive) Annual Maximum Per Person: $1,000 Preventive: Covered in Full Basic Service: Covered at 80% after deductible Major Service: Covered at 50% after deductible Orthodontia: Covered at 50% to $1,000 lifetime maximum per dependent child up to age 19 To look up a provider please log on to www.guardian.com. Customer Service-1-800-541-7846 2012-2013 Monthly Employee Contributions Single: $12.70 Family: $36.49
Vision Insurance- Provider VSP National Network of Providers- www.vsp.com Select the Network “VSP Choice” WellVision ExamSM • Thorough eye exam once a year- $10 copay Lenses every Plan Year • Fully covered, after a $25 copay • Single vision, lined bifocal and lined trifocal • Polycarbonate lenses for children Frame every other Plan Year • $130 allowance • Plus, 20% off the amount over your allowance • You can choose contacts instead of glasses every Plan Year • Allowance of $130 applies to the contact lens exam & contacts .
Vision Insurance- Provider VSP VSP does not mail ID cards To print an ID card log on to www.vsp.com. On the left side of the page click on Member Vision Card. The members name, coverage type, client ID, doctor network and copays appear on the card. Because it is personalized, it can only be generated and printed on an individual basis, one card at a time, and not en masse. This enhanced card is a convenience for members and is not required for service. Monthly Employee Cost Single: $6.77 Employee plus One Dependent: $11.41 Employee plus Children: $11.64 Employee plus Family: $18.77
2012 and 2013 FSA Plan Years- Change from Current • Healthcare reform requires employers to reduce the Healthcare Maximum to $2,500 for calendar year 2013 • HUC-JIR has elected to offer a short plan year from 7/1/12-12/31/12 to allow a $3,500 maximum • Going forward the HUC-JIR plan will run 1/1-12/31 • 2013 Open Enrollment will be held in November for the 1/1/13-12/31/13 Plan Year
What is a Flexible Spending Account or FSA? • Pay expenses with tax-free money • Three Accounts- Health Care, Limited Purpose (for HSA participants) & Dependent Care • Voluntary election of payroll deductions • Money held in your name • Submit claim for reimbursement
Deductibles Rx Drugs Copayments Day Care Eyeglasses/Contacts Lasik Surgery Dental Work Think of what you buy with your money. . .
Eligible Expenses- see FSA packet $3,500 Maximum limit (Short Plan Year) Use worksheet to estimate total expenses Calculate total contribution Dependent Care Reimbursement Eligible Expenses- see FSA packet If married, spouse must work or attend school full-time Maximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return Flexible Spending Account Health Care Reimbursement
Limited Purpose Flexible Spending Account is a tax savings account that reimburses employees for eligible dental and vision care expenses in conjunction with a HSA. Eligible Expenses- dental and vision only $3,500 Maximum limit Use worksheet to estimate total expenses Calculate total contribution Flexible Spending Account Limited Purpose Account
Open Enrollment Summary • Health Insurance- If you would like to enroll, add or drop dependents, switch plans or cancel your coverage please complete an enrollment form. If you have no changes to make no forms are required. • Vision- If you would like to enroll in the new VSP Vision plan please complete an enrollment form. • FSA- Please complete the enrollment form and turn it into the Cincinnati Benefits department • If you would like to make any changes to your Dental, Life or Supplemental Life please contact HR for a change form. As a reminder there is not an open enrollment for Dental. If you would like to increase your supplemental life insurance evidence of insurability is required. You will be approved or declined based on your current health status. • ALL FORMS ARE DUE TO HR NO LATER THAN JUNE 11th, 2012