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Open Enrollment

Open Enrollment. 2013-2014 Employee Benefits. November 7 th , 2013. Medical Insurance. Plan Choices Blue Shield HMO Premier 35 Plan (CA Only) Blue Shield PPO 1000 Value Plan Blue Shield Base PPO 40 Blue Shield Simple Saving 3500/7000 PPO-HSA (PPO Health Savings Account)

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Open Enrollment

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  1. Open Enrollment 2013-2014 Employee Benefits November 7th , 2013

  2. Medical Insurance • Plan Choices • Blue Shield HMO Premier 35 Plan (CA Only) • Blue Shield PPO 1000 Value Plan • Blue Shield Base PPO 40 • Blue Shield Simple Saving 3500/7000 PPO-HSA (PPO Health Savings Account) • Kaiser HMO $30/$3,000 HSA Plan (CA Only) • Kaiser HMO $40/$3,000 (CA Only) • Employee’s Share of Premium • Varies by plan • Dependent Coverage to age 26 • Available on all medical plans • Refer to contribution rate sheet for premium amount

  3. Blue Shield (CA Only)Access + HMO Premier 35 Plan • Plan Highlights • No annual deductible • $35 co-pay for PCP office visits • No charge for professional services, lab, x-ray • Emergency room: $100 co-pay (waived if admitted) • Hospital: $350/ day - 3 day maximum per admission • Annual out-of-pocket maximum: $3,500 individual / $7,000 family • Prescriptions • $10 Generic/ $30 formulary , $50 Non formulary • Primary Care Physician Assignment is mandatory • No charge or copay for Preventive Care • Employee Share of Premium • $155 per month, pre-tax • Dependent coverage available at additional employee paid premiums * Refer to summary of benefits for plan details

  4. Blue ShieldPPO 1000 Value Plan • Plan Highlights • Annual deductible: $1,000 per member • $20 co-pay for initial 3 in-network office visits (calendar year) • 30% coinsurance in-network • 50% coinsurance out-of-network • $5,000 annual out-of-pocket maximum per member (in-network) • $250 brand-name drug deductible • 2-tier prescription co-pays: $15 / $30 or 30% • Non-formulary not covered • No charge or copay for Preventive Care • Employee Share of Premium • $110 per month, pre-tax • Dependent coverage available at additional employee paid premiums * Refer to summary of benefits for plan details * Refer to summary of benefits for plan details

  5. Blue Shield Base PPO 40 • Plan Highlights • Annual deductible: $4,000 individual / $8,000 family • $40co-pay for all office visits (deductible does not apply) • 40% coinsurance in-network • 50% coinsurance out-of-network • $6,000 / $12,000 annual out-of-pocket maximum (in-network) • $300 brand-name drug deductible • 3-tier prescription co-pays: $10 / $30/ $50 • No charge or copay for Preventive Care • Not H.S.A. compatible • Employee Share of Premium • $85 per month, pre-tax • Dependent coverage available at additional employee paid premiums * Refer to summary of benefits for plan details

  6. Blue ShieldSS 3500/7000 PPO-HSA Plan • Plan Highlights • Annual deductible in-network: $3,500 individual / $7,000 family • Preventive care not subject to deductible – No charge or copay • Deductible applies to all other covered benefits • 20% co-insurance in-network after deductible • 50% co-insurance out-of-network after deductible • Annual out-of-pocket maximum: $4,500 individual / $9,000 family • After deductible - 3-tier Prescription co-pays: • $10 / $30 / $50 • Employee Share of Premium • $100 per month, pre-tax • Dependent coverage available at additional employee paid premiums * Refer to summary of benefits for plan details

  7. Kaiser Permanente$30 / $3,000 HSA Plan (CA Only) • Plan Highlights • Annual deductible: $3,000 individual / $6,000 family • Preventive care not subject to deductible – No charge or copay • Deductible applies to all other covered benefits • $30 office visit copay after deductible • 30% for most major medical after deductible • Annual out-of-pocket maximum: $5,950 individual / $11,900 family • After deductible - 2-tier prescription co-pays: • $10 / $30; non-formulary not covered • Must obtain all services at a Kaiser facility • Employee Share of Premium • $90per month, pre-tax • Dependent coverage available at additional employee paid premiums * Refer to summary of benefits for plan details

  8. Kaiser Permanente $40/$3000 (Not HSA Eligible) • Plan Highlights • Annual deductible: $3,000 individual / $6,000 family • Preventive care not subject to deductible – No charge or copay • Deductible is waived for office visits and prescriptions • $40 office visit copay • 30% for most major medical after deductible • Annual out-of-pocket maximum: $6,000 individual / $12,000 family • After deductible - 2-tier prescription co-pays: • $10 / $35; non-formulary not covered • Must obtain all services at a Kaiser facility • Employee Share of Premium • $95 per month, pre-tax • Dependent coverage available at additional employee paid premiums

  9. HSA Overview • Also known as a “Medical IRA” • Provides vehicle for employees to set aside pre-tax funds (outside of plan premiums) for payment of medical expenses • No time limitation for use of funds • Funds accrue and accumulate (roll-over) year to year • Funds are FDIC insured and accrue interest • Investment options are available • Contributions are made pre-tax from payroll • Interest and distributions for qualified expenses are tax-free* • Use tax-free* funds to pay for medical expenses(and non-covered dental and vision expenses) * Federal Tax-free only – CA state taxes still apply Note: Government regulations prevent HSA participants from having dual-coverage (i.e. participants are not eligible to also be covered under their spouse’s plan)

  10. HSA Logistics • Self-Managed Health Care • Responsible for payment of all medical bills, including prescriptions up to the plan deductible • Once deductible is met, “traditional” aspect of plan takes affect with respective in-network or out-of-network co-insurance • Contributions • aap3 contributes $20 per month to participant’s HSA account • You may contribute up to the IRS allowable amount less the company contributed amount each calendar year: • $3,300 individual maximum / $6,550 family maximum for 2014 • You can change your contribution election any given month • HSA Account • May never “withdraw” (reimburse) more than what is in the account at the time of reimbursement • Visa Debit Card vs. Paper reimbursement request

  11. Co-Insurance based on In-Network or Out-of-Network Services 100% Annual Deductible Pre-Annual Deductible Insured pays 100% of negotiated costs from H.S.A. (Except preventative care and wellness benefits) 0% How Does theHSA Work?

  12. GuardianPPO Dental Plan • Plan Highlights: • 100% paid for preventive services • 80% paid for basic services • 50% paid for major services • $50 deductible (waived for preventive care) • $2,000 annual benefit maximum per person • $1,500 lifetime orthodontia benefit • Employee Share of Premium • $20 per month, pre-tax • Dependent coverage available at additional employee paid premiums * Refer to summary of benefits for plan details

  13. Guardian – VSP 12/24 Vision Care Plan • Plan Highlights: • Exam & lenses available every 12 months • Frames available every 24 months • $10 co-pay – exams • $25 co-pay – glasses or lenses • Employee Share of Premium • $5 per month, pre-tax • Dependent coverage available at additional employee paid premiums • Guardian vision enrollment will match current enrollment unless new vision enrollment form is submitted * Refer to summary of benefits for plan details

  14. GuardianEmployee Assistance Program • Available to all employees • Access to licensed counselors for: • 3 face to face sessions with a counselor free of charge • Licensed counselors available by phone 24/7 • Masters level counselors • Unlimited telephone calls for counseling • Online assessments (health / wellness / stress)

  15. GuardianDisability & Life • Short-Term Disability • Benefit is 60% of weekly salary • Maximum benefit is $1,500 /wk • Benefit is offset by state disability or other earnings • 8 day elimination period • Benefit duration is 12 weeks • Long-Term Disability • Benefit is 67% of monthly salary • Maximum benefit is $8,000/mo • Elimination period is 91 days • Own Occupation for life of benefit • Benefit is offset by state disability or other earnings • Life Insurance Benefit • Flat $50,000 • AD&D $50,000 • Conversion privileges included • Living benefits option

  16. Timing, Paperwork & Contacts Benefits Program 2013

  17. Making Changes? • All new members must complete an Enrollment Application • Employees electing a new plan or changing dependent status must complete the Subscriber Change Request Form • Vision/ Dental plan paperwork only needed for changes in election/decline • Complete and submit all forms to aap3 HR by 12:00pm Noon (PST) on: Thursday, November 21, 2013 • Fax: 1-408-886-9424 • Email: hrus@aap3.com • Benefits Plan premium contribution rates will reflect in the December 2013 payroll cycle

  18. Who to Contact About Benefits? • Overall Benefit Program or Benefit Plan Questions • aap3 HR (HRUS@aap3.com) • Individual Specific Insurance Plan & Coverage Questions • Bedrosian & Associates • Alex Bedrosian , Acct Mgr(650) 367-0259alex@bedrosian-associates.com • Forms & Insurance Plan Information • aap3 HR • Primary Plan Provider Websites: • Blue Shield (Medical) • www.blueshield.com / www.blueshieldca.com • Kaiser (Medical) • www.kaiserpermanente.org • HSA Bank (HSA) • www.hsabank.com • Guardian (Dental, EAP, Disability & Life) • www.guardian life.com • VSP (Vision) • www.vsp.com

  19. Any Questions? 2013 - 2014 Benefit Plans – Open Enrollment November 7th , 2013

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