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Your 2012 Benefits Employee Meeting. Partnering for a Healthier Community November 2011. Content:. Enrollment What’s new for 2012 Introducing Health Advocate Choosing the right medical plan Incentives Flexible spending accounts Dental and vision Answer your questions.
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Your 2012 BenefitsEmployee Meeting Partnering for a Healthier Community November 2011
Content: • Enrollment • What’s new for 2012 • Introducing Health Advocate • Choosing the right medical plan • Incentives • Flexible spending accounts • Dental and vision • Answer your questions OpenEnrollment November 1 – November 30
What you can do during Open Enrollment • Other benefits:: • Employee Assistance Program • No enrollment • Long-term disability insurance • University paid • No enrollment • Tax-Deferred Retirement Savings Plan • Join • Increase contributions • Invest • Elect or change medical plan options • The HRA Plan or the Choice Plus PPO Plan • Dental and vision benefits are included • Set aside money in a flexible spending account • Health care or • Dependent care or • Both • Add life insurance or increase coverage for you and your family
Do you have to enroll? • Yes, if you want to: • Change your current medical plan • Add more life insurance • Add dependents • Add or continue a flexible spending account – your election does not carry over to next year • No, if you want to continue your current elections and do not want to participate in a flexible spending account
What’s new in benefits beginning January 1, 2012 • Introducing Health Advocate • New contribution rates • Changes to the pricing tiers in the prescription drug plan
Health Advocate • Who is Health Advocate? • National advocacy and assistance company • Mission: to help individuals get the very best health care services • A health care professional is a phone call away • 866-695-8622 • Enroll in a medical plan and a Personal Health Advocate will be a resource for: • Learning more about your health condition or diagnosis • Identifying the right doctors and specialists • Resolving medical billing and claim issues • Assisting with elder care and Medicare issues • You, your spouse and children, your parents and the parents of your spouse are all covered • No cost to you
What else is new beginning January 1, 2012 • New payroll contribution rates for the medical plans • See the rate sheet with your enrollment materials • Remember, you can lower your rates by completing your Personal Wellness Profile • Changes to prescription drugs • Some prescription drugs will change tiers or clinical programs • Lipitor will have a generic-equivalent that will cost more than the Lipitor brand name, meaning the brand name will be in a lower-cost tier • Go to myUHC.com or call the phone number on your ID card for more information 7
Which medical plan is right for you? Two choices in medical plans: The HRA Plan The Choice Plus PPO Plan 8
3 4 When you have claim activity, you will receive a Statement. UnitedHealthcare pays provider from HRA If HRA is spent1. Provider bills you for payment 2. After deductible, provider bills you for your share of coinsurance 2 1 Present ID cardto doctor Doctor sends claim to UnitedHealthcare UnitedHealthcare applies network discount The HRA PlanPayment process 1 3 4 Present ID card to doctor. Doctor sends claim to UHC. If no HRA funds available and you have paid your member part, health coverage will pay provider. If you owe coinsurance, provider will bill you for your portion. When you have claim activity, you will receive a Health Statement. TIP: Use your FSA to help you pay out-of-pocket expenses after your HRA is spent
Learn more at Health Care Lane www.healthcarelane.com/valparaiso Click on “Campbell’s Auto Care.”
The Choice Plus Plan Out –of-network providers have a separate annual deductible and out-of-pocket maximum. For maximum value, use in-network providers. See the Benefits Decision Guide for details.
Preventive vs. non-preventive Preventive care: Routine annual screenings to “prevent” illness or injury Non-preventive care: If diagnosed with a condition, some screenings often considered part of treatment. Be sure to talk to your doctor. More information on preventive care coverage can be found at www.uhcpreventivecare.com
Pharmacy - The HRA Plan Your HRA and you pay actual cost of medications until the HRA Plan’s annual deductible is met Then, you pay 20% coinsurance for covered medications (pay coinsurance at the pharmacy) Up to the HRA Plan’s annual out-of-pocket maximum; then the HRA Plan pays 100% 16
The pharmacy payment process – The HRA Plan 3 4 When you have claim activity, you will receive a Health Statement. You pay pharmacy any copayments or amounts not covered by available coinsurance 1 2 Present ID cardto pharmacy. Pharmacy verifies eligibility and any amount you owe at the point of sale. 1 3 4 Present ID card to pharmacy. Pharmacy verifies eligibility online with Medco. At the same time, the pharmacy is notified by Medco (if they are the pharmacy vendor) of any amount you owe at the point of sale. You pay pharmacy any co-pays or amounts not covered by available coinsurance or HRA funds. When you have claim activity, you will receive a Health Statement. 17
How can you reduce your medical plan’s payroll contributions? • Complete a Personal Wellness Profile questionnaire • Between November 10 and December 8, 2011 • And reduce your rates for 2012 • Must complete every year to continue the reduction Your health information is confidential and protected by the HIPAA Privacy Rule. The University does not have access to individual health date or Personal Wellness Profiles. 18
How to earn your discount Schedule your appointment Show up for your 20-minute screening Receive your Personal Wellness Profile Go online to complete the questionnaire Visit your doctor to discuss the results – this consultation is covered as preventive care See the rate sheet for rate comparison 19
What is a Flexible Spending Account? Flexible spending accounts, or FSAs, help you pay for out-of-pocket health care or dependent care expenses. 21
How FSAs work • You sign up each year to have a certain amount deducted pre-taxfrom each paycheck • When you have out-of-pocket eligible expenses, you can use your FSA to reimburse yourself for those costs • Eligible expenses are defined by the IRS 22
How FSAs work • Plan carefully, start small until you gain experience • FSA funds must be spent within the plan year or balance is forfeited • Funds do not roll over year to year • But, you have a “grace period” of up to 2½ months following end of plan year • Spend by March 15 of the following year • File by March 31 of the following year 23
Health care FSA • You can set aside $8,000 for 2012 • Use it for (but not limited to): • Copayments and deductibles • Dental and vision expenses • Hearing aids • Prescription drugs • Certain over-the-counter medications, if prescribed by a doctor 24
Dependent care FSA • You can set aside up to $5,000 for 2012 • Use it for: • Qualified day care expenses for children under 13 • Adult dependents not capable of caring for themselves • Babysitters, day care and day camps may qualify 25
Managing your FSA is easy with myuhc.com • View your medical and FSA claims online • Use direct deposit • Money deposited right into your personal checking or savings account • Saves paper … go green! • Turn on auto-rollover • Pay out-of-pocket and money automatically transfers to your FSA • If you enroll in the HRA Plan, eligible expenses are automatically paid from your HRA first, then your FSA 26
Other resources at myuhc.com • Find network doctors/hospitals • Estimate costs • Track claims status • Build a health improvement program • Keep a Personal Health Record • Get health product discounts • Review plan details 27
Dental benefits Included with medical plan Preventive care: Plan pays 100% (no deductible) Deductible: $50 deductible for single or $150 for family The plan covers Basic services at 80%, such as oral surgery and root canal therapy, after the deductible Major services at 50%, such as crowns, dentures and bridges, after the deductible Annual maximum benefit is $1,000
Vision care benefits Included with medical plan In-network benefits After $10 copay, the plan pays: 100% for lenses (single, line bifocal or trifocal or lenticular) Up to $130 for frames (retail) Up to $105 for contacts Once every 12 months
How to enroll • Go to secure.healthx.com/Valparaiso.aspx to enroll by November 30 • Returning users: see instructions as your username and password will be reset • New users: see instructions for creating a username and password • Be prepared – • Have Social Security numbers and birthdates for everyone you enroll • Your date of hire and Social Security Number and phone number 30
Most important • What you put into the system, is what you get • Be careful entering your benefits, coverage information and dependent data • An error may result in no benefits for 2012 or no coverage for you or a dependent • Check your confirmation email • Enrollment Deadline is November 30 31
Questions? 32