1 / 39

Disclaimer

Disclaimer. Each person’s needs for health care vary. You are responsible for reviewing and researching the information provided based on your own needs and circumstances. Decisions you make about your benefits should be made based on specific knowledge of your own needs. 

thelma
Download Presentation

Disclaimer

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Disclaimer • Each person’s needs for health care vary. You are responsible for reviewing and researching the information provided based on your own needs and circumstances. • Decisions you make about your benefits should be made based on specific knowledge of your own needs.  • Cost information provided is illustrative only and is not to be used or mistaken for legal guidance. • You should consult a financial or tax advisor to discuss your individual situation. • All financial investment information should be reviewed with a financial professional.

  2. Session Objectives • Provide you with overview of the 2012 Annual Benefits Program and Enrollment Process • Introduce the Plan Designs and Changes • Describe the Wellness and Incentive Plan • Help you understand your options

  3. Montgomery County / Employee Partnership • Montgomery County remains committed to providing our employees with a benefit package that offers practical, high-quality options to eligible employees and their qualified dependents. • The plan design includes wellness incentives to help employees Take Charge of Your Health. • We are certain you’ll find an option that works for you and your family.

  4. What’s New Overview • Annual Enrollment is April 25 through May 24, 2012 • You must go online and make an election, even if you are waiving medical coverage. • The effective date of benefits is July 1, 2012 • Buy-Up Plan office visit co-pays increasing $5.00 • New Feature- MChealthPERX offers telemedicine and other lifestyle benefits • Spouse now eligible for incentive • New Enrollment System and Website Details on all benefits are outlined in your Enrollment Guide and online at www.mcbenefits.org

  5. Vendors and Providers effective July 1, 2012 Things you need to know: • Medical – Anthem • Pharmacy – Medco • Dental – Superior Dental • Life & Short-Term Disability – Hartford • Vision - EyeMed • FSA/COBRA - Business Plans, Inc. • MC Work/Life Solutions – Value Options • Telemedicine and other Lifestyle Benefits –healthPERX • Wellness & Disease Management – Healthways Things you need to do: • Review your Enrollment Guide • Make your Benefits Elections April 25 through May 24, 2012

  6. Annual Enrollment is April 25 through May 24, 2012 Things you need to know: • All enrollment must be done online – including election of the waiver option • The enrollment system will be available April 25 through May 24, 2012 • Go to www.mcbenefits.org for detailed instructions on how to access the system Things you need to do: • Review your Benefits Enrollment Guide for detailed information • Everyone must make an active online election or you will be enrolled by default in the County Plan, Single coverage

  7. What does default mean? Default occurs when you fail to enroll or to complete your on-line benefits enrollment by midnight May 24, 2012. If you default: • You will automatically be enrolled in the County Plan with single coverage • There will be no coverage for your dependents • You will not be eligible for any payroll deductions for your HSA • You will not be eligible for the County Matching contributions to your HSA • You will not be eligible for incentives • You will not have dental, vision, supplemental life or short-term disability benefits • This will occur even if you had coverage in 2011

  8. Dependent Eligibility* Things you need to know: Dependent eligibility documentation is required only for newly added dependents Documentation must be submitted directly to the County HR Department by May 24, 2012. Medical Eligibility • Children up to age 26 can be included on your medical plan • No additional cost unless your enrollment level changes Dental, Vision and Supplemental Life • Children age 19 to 25 can be included on your plan(s) • Must meet the requirements of an IRS Dependent Dependent Changes After Annual Enrollment • Can only be made if you have a change in family status known as a Qualifying Life Event (QLE) * Employee eligibility is based on regularly scheduled work hours and may vary among County agencies – check with your Human Resources Department regarding your eligibility

  9. Dependent Eligibility Things you need to do: • Review the eligibility matrix in the Enrollment Guide for complete details regarding dependent eligibilityand Qualifying Life Events (pages 3 and 17) • Ensure required documentation for dependent additions or changes is received by the Benefits Department at 451 W 3rd St. by May 24, 2012, 5:00 p.m. or the dependent will not be covered for the new plan year

  10. Things you need to know – Medical Options Waiver Option • You may choose not to be covered by a Montgomery County health plan if you have coverage outside of Montgomery County • Select the waiver option on the enrollment screen • Provide other coverage information in the Enrollment System as requested • Monthly Waiver Credit: $57.50 Employee only $90.00 Employee +1 $120.00 Family • If you are covered on a Montgomery County plan as a dependent under a spouse or parent’s plan, you are NOT eligible for the waiver credit • Select the “covered under another Montgomery County employee” option on the enrollment screen

  11. Medical Plan Coverage 2 Medical Plan Offerings: County Plan and Buy-Up Plan Things you need to know about both plans: • Comprehensive coverage • Wellness and preventive care services are covered at 100% - In Network • Access to over 80% of doctors and 90% of hospitals nationwide • Medical Services covered • Prescription drug plan • Discounted rates with providers

  12. Things you need to know – Medical Options Buy-Up Plan • Network is Anthem Blue Card PPO • PPO plan with co-pays for in-network doctor office visits and prescription drugs • Deductibles, coinsurance and out-of pocket maximum for other services, i.e., x-rays, labs • Member pays co-payment at the time of service • Co-payments are not applied toward deductible • Monthly employee contributions are $170, $240 or $300 based on enrollment level* • Employees enrolled in the Buy-Up Plan will receive new identification cards *Does not include any incentive amounts Additional plan details on page 5 of your Enrollment Guide and mcbenefits.org

  13. Things you need to know – Medical Options County Plan • Qualified High Deductible Health Plan (HDHP) – also known as Lumenos • Member pays 100% of the costs for medical care and prescription drugs until the deductible is met • All charges are applied toward deductible ($1500 – single; $3000 - employee +1 or family) and out of pocket maximums • After the annual out-of pocket maximums are reached ($3600 – single; $5200 – employee +1 or family), no additional costs for in-network services • Entire Family Deductible must first be met before co-insurance is applied • Works well with Health Savings Account (if eligible and/or selected) • If enrolling in County Plan for the first time, you will receive a new ID card • Must show your Medco card at the pharmacy to receive discount rate and to assure that pharmacy charges are applied to the deductible • Monthly employee contribution ($10, $20, $30) Additional plan details on page 6 of your Enrollment Guide and mcbenefits.org

  14. 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. Refer to www.irs.gov to review the rules before you sign up. You can open an HSA if you: • Are enrolled in The County Plan, because it features all the components necessary to be a qualified health plan • Are a U.S. resident but not a resident of Puerto Rico or American Samoa • Are not enrolled in Medicare • Are not claimed as a dependent on another individual’s tax return • Are not active military • Others – refer to online health site • Go to IRS.gov or HSAmember.org for more information • Additional plan details on page 7 of your Enrollment Guide and mcbenefits.org

  15. Health Savings Accounts an option for County Plan enrollees Things you need to know: • The Health Savings Account (HSA) is a tax-advantaged medical savings account available to employees who are enrolled in a High Deductible Health Plan (HDHP), i.e. the County Plan • HSA funds can be used to pay for approved medical expenses such as deductibles and coinsurance in The County Plan • Contributions to your HSA may be made via payroll deductions that the County will administer on your behalf • You must have an active HSA to receive funds via payroll deduction, including matching County contributions and incentive earnings. • Montgomery County will match your pre-tax HSA contributions made via payroll deductions up to a total match of up to $1,000; this is in addition to the incentive credits earned by you and deposited by Montgomery County • If you do not make a contribution via payroll deduction there will be no matching contribution made by the County – this includes interruptions in contributions due to unpaid leave of absence, insufficient pay to cover scheduled contribution and/or receiving short term disability benefits • Additional contributions may be made by lump sum, Electronic Funds Transfer (EFT) or combination (MC will not match these contributions) • Annual contribution amounts are elected during annual enrollment and may only be changed as a result of a Qualifying Life Event (QLE)

  16. Things you need to know about your HSA • Mellon Bank is the HSA administrator and you must activate an account with Mellon Bank by June 30th if eligible and enrolled in the County Plan • You will receive information directly from Mellon on how to establish your account • For 2012, you may contribute*: • Maximum Contribution*Coverage Level • $3,100 Single • $6,250 EE+1, Family *Employees age 55 years or older may make an additional $1,000 contribution to their HSA * The incentive contribution period is a full 12 months. Be sure to calculate your HSA contributions or you may over-contribute and create a tax liability situation for yourself. • You will receive a debit card and checks to access the funds in your account • You can order additional check directly from Mellon Bank for a small fee • Funds must actually be in your account before you have access to them – like a regular checking account • County Plan/HSA Informational Workshops are scheduled to explain this medical plan option in more detail • If you do not open your HSA account: attempts will be made to deposit contributions and incentives for 60 days. After 60 days, if the account is still not open or is inactive, you will forfeit those monies. If the account is opened at a later date, you will need to notify HR to begin your contributions. No retroactive contributions will be made.

  17. Things you need to do concerning your HSA • Attend a session of the County Plan/HSA Informational Workshops • Check your eligibility status for the HSA • Select a contribution amount during Annual Enrollment (if eligible) – contribution amounts cannot be changed after annual enrollment • Be sure to open your account if you are a new enrollee • If you had an HSA in 2011, be sure your account is active • Reply to correspondence for additional information from Mellon – your account may be frozen for failure to respond

  18. Plan Comparison - Monthly Employee Contributions Rates shown do not include Wellness Incentives Note – Rates may change, January 1, 2013 Rates may vary by union affiliation

  19. Things you need to know – Prescription Drugs • Prescription drug coverage is included in your medical plan • Prescription drug plans are administered by Medco • There is a separate card from the prescription drug plan provider • You do not have to make a separate election from the medical plan to access the pharmacy benefits Additional plan details on page 8 of your Enrollment Guide and mcbenefits.org

  20. New Program – MC healthPERX Things You Need to Know • MC healthPERX is a telemedicine and lifestyle benefits program. • Available to all employees enrolled in a Montgomery County Medical Plan at no additional cost • Consult A Doctor • Feature of the healthPERX program • Offers 24/7 access to U.S. licensed physicians for medical consultations via telephone and secure e-mail • Provides treatment of non-emergency, acute, short-term conditions involving routine primary care • Provides medical advice and care for ailments such as cold and flu, upper respiratory infections, sinusitis, upset stomach, etc. • Prescribe non-narcotic medication for a common illness or a refill • No cost to the employee for the consult • Doctor’s Statements will not be provided

  21. New Program – MC healthPERX Things You Need to Do • Look for Member Kit and Membership cards to arrive in the mail by July 1, 2012 • Complete member profile to receive services See page9 of the Enrollment Guide

  22. “Take Charge of your Health” is the Wellness Plan • Things you need to know: • The Wellness program is named “Take Charge of Your Health” • “Take Charge of Your Health” offers many programs including Tobacco Cessation, Stress Management, Weight Management and Coaching • You can use the wellness benefits even if you don’t enroll in a Montgomery County Health Plan • You must complete the Well-Being Assessment to participate in the program • Montgomery County’s wellness program will be administered by Healthways • All information Healthways collects is confidential, governed by Federal Privacy Laws • Montgomery County will not see any of your personal health information • The Well-Being Assessment will be available to you online on April 25, 2012 at https://takecharge.embrace.healthways.com or link through www.mcbenefits.org

  23. “Take Charge of your Health” is the Wellness Plan Things you (and your spouse) need to do: • Complete a new online Well-Being Assessment (WBA); employee and spouse complete separate assessments • Get your annual physical and age and gender appropriate tests • If you receive a phone call from a Healthways nurse, answer the phone and talk with the nurse. This is a free resource that can help you with: • Understanding your WBA Report • Nutrition Support • Crafting questions for your doctor • Managing your chronic disease • Share your personalized Well-Being Assessment Report with your doctor • Use the resources available on the website – all are free for you and your family!

  24. Employee Incentive Package can impact your monthly employee contributions!! Things You Need to Know: • You must be enrolled in either the Buy-Up Plan or the County Plan with a Health Savings Account • Each employee incentive award is worth $50 per month • Each spouse incentive award is worth $10 per month • Either or both of you must complete the eligibility criteria in order to receive the incentive(s) • There are two Incentives available to eligible employees: • Living tobacco free • Completed the Wellness Activities (must complete all 3) • Getting an annual Physical • Having appropriate age and gender tests • Completing your Well Being Assessment (WBA) • Incentives are awarded differently depending on medical plan: • Buy-Up Plan = Reduced Monthly employee contribution (pg. 5) • County Plan = Monthly HSA deposit

  25. EMPLOYEE INCENTIVE PACKAGE Things You Need to Do: • If enrolled in the County Plan you must have an active Health Savings Account • Employee must complete the on-line benefits enrollment with responses to questions by May 24, 2012 (print confirmation sheet) • Well Being Assessment – May 24, 2012 (print confirmation sheet) • Annual Physical must be completed between April 1, 2011 and June 30, 2012 • Appropriate age and gender tests must be completed between April 1, 2011 and June 30, 2012

  26. Flexible Spending Accounts (FSA) Things you need to know: • myCafeteria Plan is the FSA administrator • Types of accounts: Health Care, Dependent Care and Limited Purpose FSA • Set aside tax-free money each pay period to meet eligible expenses incurred during the year • Annual limit on pre-tax contribution is $5,000 for all accounts • The IRS requires any balances remaining in the account after June 30, 2013 to be forfeited • Health and Dependent Care FSA accounts are available for use with the Buy-Up Plan • You may contribute to one or both accounts – health care and dependent care • Limited Purpose FSA • Reimbursements are limited to eligible dental and vision expenses only • Dependent Care FSA is also available Things you need to do: • Make a contribution election for either the FSA option(s) you desire • You must make your election during annual enrollment April 25 through May 24, 2012 • Go to www.mcbenefits.org for detailed instructions and information

  27. Comparing HSAvs. FSA

  28. Vision Coverage Things you need to know: • EyeMed is the plan administrator • Provides benefits for eye exams, lenses, frames and contact lenses • In-Network and Out-of-Network providers are included in the plan • No change in employee contributions Things you need to do: • Review the annual enrollment materials • Review the plan and make an informed decision • Make an election during annual enrollment April 25 through May 24, 2012

  29. Dental Coverage * Things you need to know: • Superior Dental is the plan administrator • You may participate if you are benefits eligible, even if you don’t participate in a Montgomery County medical plan • Preferred Plan Network is the network of dentists • The two plan designs are: Core and Enhanced Things you need to do: • Review detailed plan features in the annual enrollment materials • Compare the plans and make an informed decision • Make an election during annual enrollment April 25, 2012 through May 24, 2012 *Dental coverage does not apply to employees at MCBDDS and PHDMC **Core Plan does not apply to employees at ADAMHS

  30. Life Insurance Things you need to know: • The Hartford is the life insurance plan administrator • $50,000 Basic Life and AD&D is provided to employee at no cost • You may purchase supplemental life insurance for you and your spouse or dependent children at your own expense • Does not apply to PHDMC or MCBDDS • To enroll or increase your supplemental life insurance, a Personal Health Application (PHA) must be submitted to The Hartford by May 24, 2012 • The PHA is available on the enrollment site or at www.mcbenefits.org/forms • You may decrease or cancel your Supplemental Life Insurance during annual enrollment Things you need to do: • Review detailed plan features and rates in the annual enrollment guide or at www.mcbenefits.org • Compare the plans and make an informed decision • Submit PHA to The Hartford if enrolling or increasing supplemental life insurance by May 24, 2012 • The enrollment system will be available April 25 through May 24, 2012

  31. Short Term Disability Coverage Things you need to know: • The Hartford is the plan administrator for Short Term Disability (STD) benefit • Provides benefit of 60% of your base pay for up to 26-weeks after • 14 day waiting period for illness • 7 day waiting period for injury • Rates are based on your age and base pay • Does not apply to ADAMHS, PHDMC or MCBDDS • A Personal Health Application (PHA) must be submitted to The Hartford by May 24, 2012 to enroll in the plan • The PHA is available on the enrollment site or at www.mcbenefits.org/forms • Departmental policies vary regarding the use of earned leave prior to STD Things you need to do: • Review detailed plan features and rates in the annual enrollment guide • If enrolling for the first time, submit completed PHA to The Hartford by May 24, 2012 • Select STD option during the open enrollment period (April 25 – May 24, 2012)

  32. MC Work/Life Solutions Things you need to know: • MC Work/Life Solutions offers free and confidential counseling to you and your family members to help you deal with personal issues • Counselors available 24 hours a day, 365 days a year • Work/Life services assist with daily issues such as • choosing a child care provider • financial services and care for adults • selecting a school or a college • assisting with parenting issues • moving, relocation and home ownership • Services are available at no cost • No enrollment is required Things you need to do: • Visit the website @ www.achievesolutions.net/mcohio for a full list of services and additional work/life resources

  33. Enrollment Checklist *See pages 18 and 19 for a complete checklist

  34. Front page of enrollment site

  35. Front page of website

  36. ANNUAL ENROLLMENT – SUMMARY • Review your annual enrollment guide • Attend an annual enrollment meeting • If considering the County Plan, attend a County Plan/HSA Informational session • Check your HSA eligibility status • Go to mcbenefits.org for more information • BE SURE TO GO ON-LINE AND ENROLL BETWEEN APRIL 25 AND MAY 24, 2012

  37. Disclaimer • Each individual’s needs for health care can vary. • Decisions you make about your benefits should be made based on specific knowledge of your own needs.  • Cost information provided is illustrative only and is not to be used/mistaken for legal guidance. • You should consult a financial or tax advisor to discuss your individual situation. • All Financial investment information should be reviewed with a financial professional.

  38. Any Questions??????

More Related