2015 Employee Benefit Meeting This PowerPoint presentation is for illustrative purposes only. In the event there appears to be a contradiction between the benefits described and those provided by respected carriers Summary Plan Descriptions, the Summary Plan Description shall prevail.
AGENDA � Medical Plan Options � HSA- Health Savings Account � Payroll Deductions � Dental � What You Need To Do - Online Open Enrollment
Plan Changes All Plans will continue to utilize the Blue Cross network through Independence Administrators � No Changes to Current plans � Changes to Medical Plan Contributions – you choose how you want to fund your medical plan option � Aflac offerings continue to be available for January 1, 2015
PTL WHITE Member Needs Medical Services Participating Providers Non-Participating Providers In-Network Out-of-Network � � $300 / $600 Deductible $15 Office Visit Co-pay � � $70% coinsurance for office visits after $15 Specialist Co-pay � deductible Emergency Room $75 co-pay � � Emergency Room $75 co-pay Unlimited Lifetime Maximum � � Unlimited Lifetime Maximum Prescription Drugs: $10/$25/$40 � Prescription Drugs: not covered There are out of network benefits, coinsurance applies after deductible The deductible for out of network benefits is $300 for an individual and $600 for families. You must meet that deductible, out of network, before benefits will start to pay on out of network claims
PTL BLUE Member Needs Medical Services Participating Providers Non-Participating Providers Deductible - $750 Ind/ $2,250 Family $1,000 Ind/ $3,000 Family Deductible � � $35 Office Visit Co-pay Office visit: 70% coinsurance, after deductible � � $45 Specialist Co-pay Specialist: 70% coinsurance, after deductible � � $300 Emergency Room Co-pay (waived if $300 Emergency Room Co-pay � � admitted) Inpatient hospital Services, 70% after � Inpatient Hospital Services, covered 100%, deductible � after deductible Outpatient Surgery, 70% after deductible � Outpatient Hospital Services, covered 100% Unlimited Lifetime Maximum � � after deductible Prescription Drugs: not covered � Unlimited Lifetime Maximum � Prescription Drugs: $10/$25/$40 � There are out of network benefits, coinsurance applies after deductible Calendar Year Deductible — A Covered Person must satisfy the individual deductible amount only once during a calendar year. However, after the Covered Persons in a family unit have satisfied the family deductible amount during a calendar year, benefits will be payable for covered medical charges incurred for all Covered Persons in a Family Unit for the remainder of that calendar year.
PTL HSA Member Needs Medical Services Participating Providers Non-Participating Providers � $1,500 Ind/ $3,000 Family Deductible � $3,000 Ind/ $6,000 Family Deductible � Office visits,$15 copay after deductible � Office visits, 70%, after deductible � Emergency Room, $75 copay after deductible � Emergency Room, $75 copay after � Inpatient Hospital Services, 100% after deductible deductible � Inpatient hospital Services, 70% after � Outpatient Hospital Services, 100% after deductible deductible � Outpatient Surgery, 70% after � RX copays, $10/$25/$40, after deductible deductible � Unlimited Lifetime Maximum � Unlimited Lifetime Maximum All services except Preventive services are subject to the Calendar Year Deductible: Individual : If you are enrolled in an individual Health Savings Account, you must meet the individual Calendar Year Deductible before any benefits are payable. Family Aggregate: If you are enrolled in a Family Health Savings Account, you and/or any members of your family must meet the Family Calendar Year deductible before any benefits are payable.
PTL HSA 3000 Member Needs Medical Services Participating Providers Non-Participating Providers � $3,000 Ind/ $6,000 Family Deductible � $6,000 Ind/ $12,000 Family Deductible � Office visits,$15 copay after deductible � Office visits, 70%, after deductible � Emergency Room, $75 copay after deductible � Emergency Room, $75 copay after � Inpatient Hospital Services, 100% after deductible deductible � Inpatient hospital Services, 70% after � Outpatient Hospital Services, 100% after deductible deductible � Outpatient Surgery, 70% after deductible � RX copays, $10/$25/$40, after deductible � Unlimited Lifetime Maximum � Unlimited Lifetime Maximum All services except Preventive services are subject to the Calendar Year Deductible: Individual : If you are enrolled in an individual Health Savings Account, you must meet the individual Calendar Year Deductible before any benefits are payable. Family Aggregate: If you are enrolled in a Family Health Savings Account, you and/or any members of your family must meet the Family Calendar Year deductible before any benefits are payable.
HSA Plan � Stay healthy with 100% in-network Preventive Care preventive care coverage 100% In-Network � You have the option to make contributions to your account. � You can use your account dollars to pay HSA for medical care and prescription drugs Funded by employee � Medical and RX apply to deductible - you can use dollars available in your HSA. Deductible � Entire family deductible must be met before any benefits begin. � 10 0% coverage then kicks in after you have satisfied your deductible. You will only have copays.
HSA Plan – Key Features � Funds deposited into an HSA are tax- Preventive Care advantaged and owned by the account 100% In-Network holder. � Funds may be rolled over year to year; no “use-it or lose-it” rule. HSA Funded by employee � Accounts can accumulate significant assets that can be used for healthcare tax-free. Deductible � Funds are portable and available through job changes. � Funds in the HSA can be invested.
Am I Eligible for a Health Savings Account? � The IRS and the U.S. Department of the Treasury have specific rules on who can open an HSA. � You can open an HSA if you: � Are enrolled in an HSA-qualified High Deductible Health Plan (HDHP) � Cannot be covered by any other insurance that reimburses for health expenses � Are not enrolled in Medicare or Medicaid � Are not claimed as a dependent on another individual’s tax return and must be over 18 years of age
How Do I Make Contributions to My HSA? � There are several ways you can contribute to your account : � Payroll deductions: � After-tax contributions: � Anyone may contribute to your HSA, provided the total contributions to your HSA do not exceed your maximum allowable annual limit � You can make catch-up contributions if you are 55 years of age or older ($1,000)
How Much Can I Contribute to a Health Savings Account (HSA)? � Each plan year, you may contribute money to your HSA up to a maximum amount set by the U.S. Treasury and the IRS � All combined contributions to your account cannot exceed the annual contribution maximum � For 2015, the annual contribution maximum set by the U.S. Treasury and the IRS is $3,350 for individual coverage and $6,650 for family coverage � The contribution maximums set by the U.S. Treasury and the IRS may be increased for inflation annually
Payroll Deductions PTL PTL PTL PTL HSA White Blue HSA 3000 Payroll Weekly Weekly Weekly Weekly Deductions Employee $ 75.00 $ 41.00 $21.00 $9.00 Employee + 1 $ 133.00 $ 72.00 $ 39.00 $15.00 Family $ 169.00 $ 103.00 $ 49.00 $19.00 Monthly Monthly Monthly Monthly Employee $325.00 $177.67 $91.00 $39.00 Employee + 1 $576.33 $312.00 $169.00 $65.00 Family $732.33 $446.33 $212.33 $82.33 *Employees who participated in the wellness initiative (completed a health screening and online health assessment) will have no increase to their medical contributions for the plan year beginning January 1, 2015
Dental Benefits No changes to the current dental plan utilizing the United Concordia network of participating dentists • Plan Year Deductible - $50 Single, $150 Family* • Plan Year Maximum per person - $1,000 • Possible Balance billing at non-participating dentists • Diagnostic/Preventive – 100% • Basic – 80% •Orthodontia for dependent children to age 19 - 50%; $1,000 lifetime maximum *Deductible applies to: Basic services only
Dental Payroll Deductions Payroll Deduction Weekly Employee Only $5.00 Employee + 1 $11.00 Family $21.00
EmployeeConnect – Employee Assistance Program Beginning January 1, 2015, you can access online information by visiting: www.Lincoln4Benefits.com and click on the Employee Connect link User Name: LFGsupport Password: LFGsupport1 Toll-free number: 1-888-628-4824 EmployeeConnect Employee Assistance Plan offers confidential guidance and � resources for you or an immediate household family member. Short Term Counseling Services: � � Marital/Family Counseling, Depression, Addiction, Stress/Anger, Life Transitions Legal Service � � Telephonic access, referrals and consultation by ComPsych staff Attorney Financial Service � � Telephonic access to a ComPsych staff Financial Expert Work Life Services � � Unlimited telephonic access to work-life services Online and Mobile Access � � Broad range of information on the web ID Theft � � Included online and through ComPysch legal staff.
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