320 likes | 596 Views
City of Las Vegas 2012 Wellbeing Education & Open Enrollment. Timeline for Submitting Forms. Open enrollment is October 6 through November 14 Forms must be returned to Risk, Compensation & Benefits by November 14, 2011 You can Change medical plans Add or delete dependents
E N D
City of Las Vegas 2012 Wellbeing Education & Open Enrollment
Timeline for Submitting Forms • Open enrollment is October 6 through November 14 • Forms must be returned to Risk, Compensation & Benefits by November 14, 2011 • You can • Change medical plans • Add or delete dependents • Enroll in voluntary benefit programs • Enroll in the Flex plan • You must enroll each year to participate in the flexible spending account program • Please Note: If you do not want to make a change to your Group Health plan, you do not have to do anything
PART IWellness & Prevention • Behavior based – change your habits • Small steps result in BIG CHANGES • Proactive management of health • Preventative health services • Wellness • Long term approach • Develop a plan, work the plan, monitor the plan, CELEBRATE your success • Usually no or low cost • Bottom Line • live longer, • live happier, • live wealthier
First Step • Complete your Wellness Interest Survey! • Take a few minutes and allow us to identify what you want and need for Wellness • Survey copies available from Wellness Coaches or Human Resources • Return completed surveys to your coach, via email, or send via interoffice mail • All information is confidential If you return your survey by 11-14-2011 you will be eligible to win one of three $100 gift certificates.
Health Quiz I 79 Subtract your age = The number of years you have left on the planet
Health Quiz II How Many Of You Can “Say Yes” to All 5? I am within 5 pounds of my ideal body weight I exercise 30 minutes or more most days of week I eat a healthy diet with 5 fruits/vegetables most days I don’t use tobacco products I have 2 or fewer alcoholic drinks per day
Percent of Chronic Diseases That Are Caused by Poor Lifestyle 91% 82% 71% 70% Sources: Stampfer, 2000; Platz, 2000; Hu, 2001
Wellness • Key component of your health care • Preventative & Proactive • Works one-on-one and confidential • Supports behavior change, designed to assist each person at their own pace • Many of your fellow employees have been successful • Our Wellness Coaches are here to assist with:
Lifesigns • A head to toe annual preventive physical exam providing information you need to develop your personal care plan, putting you in control of your health. • Works hand in hand with Wellness Coaches, PCP and Behavior Health Benefits, 100% confidential • Lifesigns seeks to complement your relationship with your existing PCP and can forward results electronically to your physician at your request • For CH/C participants test results will be sent to Care Coordinators.
Employee Assistance Program Mines and Associates Counseling • Problem Assessment• Short Term Counseling or Referral• Coaching for Behavior modification• After-Care Follow-Up• Crisis Intervention• 24 Hour Emergency Service• Workplace Reintegration• Child or aging parent assistance
Health Quiz III • Wellness, Lifesigns, Employee Assistance Program, Preventive health services and some Behavior health services cost each CLV employee? • Nothing, these services are free to all CLV employees CONFIDENTIAL
Choose a Family Doctor/PCP • Primary Care Physician your “family” doctor • Specially trained to work with you to coordinate your overall healthcare • Understands you and your needs best • Takes the confusion out of what to do next, where to do it • An in-network PCP can help keep money in your pocket by reducing your out-of-pocket expenses • Focus on preventive and scheduled health maintenance services.
Live Longer – Live Better • Use the tools we have provided to assist you in becoming well and engaged • Lifesigns • Wellness Coaches • PCP and Prevention • EAP • Dental/Vision • Health plan
PART II 2012 Group Benefit PlansThere when you need it! CONFIDENTIAL
2012 Changes • By making small plan changes CLV has been able to keep 2012 premiums low – most are at or below 2011 rates. • Sierra PPO Changes – increase Out-of-Pocket maximum • Increase in prescription co-payments • Lower premium rates • C H/C changes – increase Out-of-Pocket maximum • Increase in co-insurance • No change in EE only and EE + 1 premium rates • Dental Plan Changes – increase from $2,000 annual maximum benefit to $2,500 annual maximum benefit • Premium rate increase
What will the “Care Coordinators” help me with? Health care is very confusing Call for Help… I can help you with all your healthcare questions. IT ALL STARTS HERE Claims Care Coordinators Network 1-877-498-5981 5:30 AM – 6:00 PM PST Monday – Friday Pharmacy Providers HR Single Point Patient Service • Benefits • Claims Questions • Find In-Network Providers • Patient Advocacy • Nurse Coaching
Let’s Review How CDH Works Bridge (Employee’s responsibility) Preventive Care 100% 100% coverage – No deduction from HRA Health ReimbursementAccount (Annual Allocation) Traditional HealthCoverage Coinsurance Maximum $2500 $3750 $5000 All employees enrolled in CDH must submit a City of Las Vegas Other Insurance Form
2012 Plan Changes • Co-Insurance (without Bridge) • Current 2012 • In-Network 90% 80% • Out – Network 70% 60% • OPM In-Network • Employee $2000 $2500 • Employee + 1 $3000 $3500 • Family $4000 $4500 • OPM Out of Network • Employee N/A $6000 • Employee +1 N/A $7000 • Family N/A $9000 • **in-network accumulates toward out-of-network max
2012 Plan Changes • Pre Notification is required for: • Outpatient surgery • MRIs, MRAs, & PET Scans • Oncology services (chemotherapy and radiation therapy) • Home health care and services • Durable medical equipment rentals and purchases over $500 • Hospice care • Speech, physical and occupational therapies • Dialysis • Prior Authorization is required for: • Transplant services • In Patient services • Gastric bypass surgery • Early notification of high cost procedures notifies Care Coordinators to assist patients through a health care event, lowering cost and improving quality. • Note: Anytime a pre-notification/auth is submitted, you will receive a confirmation letter from the Care Coordinators.
Coordinated Health/Care Pharmacy Benefit • Catalyst Rx • Formulary Advantage Program • Complete Formulary Listing • Price and Save Program - www.catalystrx.com • You can price and compare co-payments at local pharmacies • Helps you choose lower cost prescription drug options
Diabetic Sense Program • Catalyst Rx offers the Diabetic Sense program at no charge • Injectable insulin and syringes at no charge • Home delivery of testing supplies • Access to Diabetes Educators, Nutritionists and Pharmacists • To access this benefit, you must enroll • To enroll call Liberty Medical at 1-866-896-7303
Health Plan of Nevada • HMO Health Plan • Required to have PCP • Must stay in-network • No Annual Deductible and Out of Pocket Max • Co Pays for various services • Co Pay for Rx • No Out of Network benefit
2012 Sierra PPO Plan • Prescription Co-Pay • Generic $15.00 • Preferred Brand $40.00 • Non Prefer. Brand $60.00 • Deductible In-Network Out-of-Network • Employee $500 $1000 • Employee + 1 $1000 $2000 • Family $1000 $2000 • OPM In-Network Out of Network • Employee $3000 $6000 • Employee +1 $6000 $12000 • Family $6000 $12000 • Please refer to medical plan comparison chart in the 2012 open enrollment for more plan details.
Did you know? • Annual dental and vision exams are as important as an annual physical • Dental and Vision exams can detect over 120 disease signs (usually at very early stages) including: • Heart disease/Heart attacks • Diabetes • Respiratory disease • A weakened immune system that can slow healing of wounds and reduce a person’s response to hepatitis B and flu vaccines. • Cancers • Stroke CONFIDENTIAL
Dental and Vision Benefits Dental Preferred Dental Network Increase in annual benefit to $2,500 Vision Vision Service Plan Network
Section 125 Flexible Spending Accounts • Two types of funds (you must enroll annually) • Health Care FSA – contribute up to $4,000 to pay for unreimbursed medical costs • Dependent Care FSA – contribute up to $5,000 to pay for eligible day care expenses for child or dependent adult • Contributions to your FSA are pre-tax • Your taxable income is decreased • Fewer taxes are withheld • Increase monthly cash flow • Use the money when you need it • You must budget carefully, governed by IRS use-it –or-lose-it rule. CONFIDENTIAL
Voluntary Life • For employees currently participating in The Standard’s Voluntary Life plan, you can increase your benefit level: • $60,000 for employee, up to guaranteed issue amount of $150,000 • $10,000 for your spouse, up to guaranteed issue amount of $50,000 Please update or complete your beneficiary designation. CONFIDENTIAL
Deferred Compensation • 457 plan • Pre tax employee contribution • Reduces federal taxes • Provides savings for retirement Hartford ICMA Nationwide
Voluntary Programs • Discounts on Auto and Home Insurance • F. Hayden Ray702-736-8611 Ext. 58082 • Consult with Board Certified doctors on the telephone or via email regarding commonly treated short-term illnesses, such as: flu, allergies, colds, etc. • Available 24 hours a day, 7 days a week • Can prescribe medications and refill recurring prescriptions • For information, contact Lori Wilkerson at 702.877.1177 • Pat Johnson or Amy Bechtel • Phone - 702-877-6388 CONFIDENTIAL
Putting it all together CONFIDENTIAL
Information CLV Intranet Site Benefits tab Summary Plan Descriptions Claim Forms Change and Enrollment Forms Provider contacts & web sites Resources Insurance Services Dan Rigato Sandy Ray Mandee Bowler Candace Mbaye CONFIDENTIAL