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2013 Annual Open Enrollment. presentation for the employees of. September 1, 2013. 2013 Annual Open Enrollment. First, a brief discussion of HealthCare Reform Cause & Effect. 2013 Annual Open Enrollment. Utilization. Cost. 2013 Annual Open Enrollment. 2013 Annual Open Enrollment. What
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2013 Annual Open Enrollment presentation for the employees of September 1, 2013
2013 Annual Open Enrollment First, a brief discussion of HealthCare Reform Cause & Effect
2013 Annual Open Enrollment Utilization Cost
2013 Annual Open Enrollment What are the benefits for the 2013/14 plan year?
2013 Annual Open Enrollment Group Medical Plan Dual Option: HSA-Qualified Plan 1-2-3 Plan
2013 Annual Open Enrollment • HSA-Qualified Plan • $2,500 Plan Year Deductible (9/1 – 8/31) for “employee only” • $5,000 AggregatePlan Year Deductible for “employee plus dependents” • Plan pays at 80% after the Deductible is met • Plan pays at 100% after the $2,500 Coinsurance Limit is met • Total Maximum Out-of-Pocket Limit is $5,000 for “employee only” • No Copays for physician’s office visits or prescription drugs – all covered charges help to meet the Plan Year Deductible • Preventive Care is covered at 100% (does not count towards Deductible or Coinsurance)
2013 Annual Open Enrollment HSA-Qualified Plan PMG Research, Inc. will contribute $40 per month ($480 annually) to employee’s HSA account
2013 Annual Open Enrollment • 1-2-3 Plan • $2,500 Plan Year Deductible (2X family) -- $1,750/$3,500 after MERP • Level 1 -- $25 Copay for Primary Care office visits • Level 2 -- Plan pays at 90% after the Deductible and $250 per-admission Copay for Inpatient Hospital Services • Level 3 -- Plan pays at 70% after the Deductible for Specialist office visits and Outpatient Hospital Services • Plan pays at 100% after the $4,000 Coinsurance Limit is met • Total Maximum Out-of-Pocket Limit is $6,500 for “employee only” • Preventive Care is covered at 100% (no office visit Copay, and does not count towards Deductible or Coinsurance) • $10/$40/$55/25% for Prescription Drugs
2013 Annual Open Enrollment Group Medical Plan Monthly Employee Contributions
2013 Annual Open Enrollment Group Medical Plan 2013 Employee Contributions Comparison
2013 Annual Open Enrollment Which Medical Plan Should I Choose?
2013 Annual Open Enrollment • $50 Plan Year Deductible per individual ($150 per family) • $1,500 Annual Maximum Benefit per individual • Plan pays at 100% (no Deductible) for Preventive Services • Plan pays at 80% after the Deductible for Basic Services • Plan pays at 50% after the Deductible for Major Services • Plan pays at 50% for Orthodontia, to $1,500 Lifetime Maximum Benefit • www.deltadentalnc.org
2013 Annual Open Enrollment Monthly Employee Contributions Employee Only FREE Employee and Spouse $32.02 Employee and Child(ren) $64.02 Employee and Family $109.85
2013 Annual Open Enrollment • Be sure to review your current elections for: • Principal Voluntary STD • Principal Voluntary Life
presented by Lou Pierce, President Cindy Connor, Director of Employee Benefits 6518 Airport Center Drive, Suite 101 Greensboro, NC 27409 P 336.292.9050 P 877.282.1099 F 336.292.4618 www.plybon.com