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H.B. Fuller Company 2009 Open Enrollment:. Helping you Buy Well, Use Well, Be Well. October, 2008. Today’s Discussion. An overview of your plan options for 2009 Market 400 Value 750 High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) Key differences between plan options
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H.B. Fuller Company2009 Open Enrollment: Helping you Buy Well, Use Well, Be Well October, 2008
Today’s Discussion • An overview of your plan options for 2009 • Market 400 • Value 750 • High Deductible Health Plan (HDHP)with a Health Savings Account (HSA) • Key differences between plan options • Tools and resources to find the information you need • How and when to enroll PURPOSE OF TODAY’S MEETING: To help you understand your new choices in medical plan options
Key Features of Market 400 • This option is the most similar to what you have today, with the deductible and out–of- pocket maximum adjusted to be at the mid-point of the market. As this option has the lowest deductible and out-of-pocket limit, it carries the highest premium contribution. • Pharmacy: 20% member copay with a min/max of: Deductible – $400 single $800 family Out of Pocket - $1,500 single $3,000 family Generic – $10/$20 Brand – $20/$40 Non-Formulary Brand –$40/$80 Specialty Pharmacy – $80/$160 • Office visit copay -- $30 • Preventive care 100% in-network only • Deductible and coinsurance applies to X-ray and imaging, inpatient and outpatient hospital, emergency room (+$75 copay) and durable medical equipment • Office visit, pharmacy and emergency room copays do not apply to deductible or out-of-pocket maximum.
Key Features of Value 750 • This option lets you pay less in monthly premium. In exchange, you may need to pay a higher deductible before the plan begins to pay. • Deductible -- $750, $1,500 • Out of pocket limit -- $3,000, $6,000 • Premium: 40% less than Market 400 Choosing a higher deductible is similar to the decision you make when you buy car insurance. You balance what you can afford to fix yourself vs. what you want your insurance to cover. It is always more expensive when you have a low deductible. • The other plan features are identical to the Market 400. Eligible expenses are paid in the same manner in both options. • Office visit copay -- $30 • Preventive care – 100% in-network only • Pharmacy: 20% member copay with a min/max of: Generic – $10/$20 Brand – $20/$40 Non-Formulary Brand –$40/$80 Specialty Pharmacy – $80/$160 • Deductible and coinsurance applies to X-ray and imaging, inpatient and outpatient hospital, emergency room (+$75 copay) and durable medical equipment • Office visit, pharmacy and emergency room copays do not apply to deductible or out-of-pocket maximum.
Key Features of HBF’s HDHP with HSA • This means: High Deductible Health Plan with • a Health Savings Account • High Deductible Health Plan • $2,000/$4,000 deductible (total family deductible must be met) • The out-of-pocket maximum matches the deductible. The plan pays 100% after the deductible is met for eligible expenses. For 2009, HBF will contribute $500/ single and $1,000/ family • Same definition of eligible expenses as in Market 400 and Value 750 • Prescription drugs must apply toward the deductible • Preventive care is covered at 100% in-network Health Savings Account • Employees have the option to use pre-tax dollars to fund their account up to the IRS limits. For 2009, the limits are $3,000 single/ $5,950 family.
Key Features of an HSA What is an HSA? It is a savings account that is owned by you and is associated with a High Deductible Health Plan • Tax-free contributions to pay for current and/or future medical expenses • No “use it or lose it” • Interest earned tax free • Investment opportunity with tax-free growth • Flexible – you choose when or whether to use the account for health care expenses • Portable – you own the account • Banking services provided by JPMorgan Chase Bank. Some fees required. • Easy access to funds through debit card
HSA Tax-Qualified Expenses • Includes expenses such as: • Deductibles • Coinsurance • Not covered but eligibleIRS expenses • Prescription drugs • It also includes expenses for: • COBRA-continuation coverage • Health plan coverage while receiving unemployment compensation • Medicare premiums and out-of-pocket expenses • Qualified long-term care insurance Employees are responsible for keeping all receipts and records, demonstrating that HSA dollars were used for qualified health care expenses.
1 Member is not eligible to be claimed on another’s tax return HSA Eligibility Requirements to Contribute Eligibility 2 Member does not have benefits from another qualified health plan 3 Member is not currently enrolled in Medicare benefits
Health Coverage • Peace of mind • Out-of-pocket maximums Preventive Care 100% coverage for preventive care services based on age and gender as recommended under U.S. guidelines • Clearly defined out-of-pocket potential • Option to reimburse from account • Financial stake • Financial stake • Employer and /or employee dollars • Potential rollover and / or savings / investment incentives How the HDHP with HSA Works Deductible HSA
HSA funded $ 2,000 Health Coverage 100% Coinsurance Max OOP $2,000 Preventive Care $ 750 Non-Preventive3 Physician’s visits $ 360 12 Prescriptions 840 $ 1,200 Preventive Care: 100% Health Coverage $2,000 Deductible HSA Pays $ 1,200 $2,000 HSA Health CoverageEmployee Pays $ 0 Health Plan Pays $ 750 Remains in HSA for 2nd year $ 800 $800 Remaining $1,200 $1,200 HSA Paid $750 Len -- Year One – Example with Moderate Utilization Note: Assumes all in-network care.
Preventive Care: 100% Health Coverage 100% Coins. Max OOP $2,000 $2,000 Deductible $2,800 HSA $1900 Remaining $900 $900 $300 Moderate Utilization Len – Year Two – HSA Rollover fromyear one $ 800 HSA funded $ 2,000 New HSA balance $ 2,800 Immunizations $ 300 Non-Preventive5 Prescriptions $ 350 Lab work 250 3 Physician’s visits 300 $ 900 HSA Pays $ 900 Employee Pays $ 0 Health Plan Pays $ 300 Remains in HSAfor year three $ 1,900 Note: Assumes all in-network care.
Aetna processes the claim, applies the discounted rate and sends an Explanation of Benefits based on High Deductible Health Plan Benefits You visit the doctor Doctor sendsbill to Aetna You receive a bill from the provider You decide whether or not to use HSA funds How Claims Get Filed You paythe doctor
Claim Payment Comparison Participating Pharmacy Brand Rx- $125
Claim Payment Comparison In-Network Preventive Care Office Visit- $150 Contracted Rate
Claim Payment Comparison In-network Hospital Stay- $4,000 Contracted Rate
Key Differences Important things to consider when making your choice: • Understand how the deductible works • Individual vs. family • What counts, what doesn’t • Annual premium difference – do the math! If you are considering the HSA, here are additional considerations: • Prescription coverage – You pay 100% up to the deductible • Tax advantaged, portable savings. Great for retiree medical!
Tools for Choosing a Medical Plan For help in choosing the right medical plan option • Read newsletters and Enrollment Guide • Visit the Aetna website and sign up for Aetna Navigator • Try the Plan Selection and Cost Estimator Tool • Use Aetna’s Cost Estimator to determine cost of care • For “in-person” help, call • the HBF Benefits Connection (formerly FlexPlus) • Aetna
How and When to Enroll Enroll October 29 to November 11 There are no extra “grace days” this year! You MUST enroll in Medical to have coverage 1/1/09 • To enroll online or by phone, you will need: • your 6-digit employee ID (on your pay stub) • Your PIN (Unless changed, PIN is last four digits of SSN) • Either elect or waive coverage for each available category • Print and review confirmation at end of session • Confirmation also sent to you by mail. Confirm elections, send in any additional information required and correct errors within 10 days by calling 800-798-5446 (no corrections online after Nov 11)
Thank you for your time! Questions?
Why Changes Are Being Made • Assure benefits program is competitive at mid-point to the market • Provide choice to employees • Consolidate vendors in order to: • Offer same benefits to all employees • Better maximize value • Reduce administrative cost and complexity • Adjust contribution and rate setting processes to: • Better manage high cost of program • More fairly share costs between employees and retirees • Involve employees in data-driven decisions • Build a Culture of Health