2019 20 Benefits Open Enrollment 2019-20 Benefits Update Staff, - PowerPoint PPT Presentation

2019 – 20 Benefits Open Enrollment

2019-20 Benefits Update Staff, Fixed Term Faculty, Medical Faculty & Post- Doctoral Research Fellows

Benefits Open Enrollment – Elections Required MANDATORY Open Enrollment for 2019-20 • IMPORTANT! All benefit-eligible Benefit Year faculty and staff will be required to actively elect benefits online via CMU Choices for: – Dental: Default to CORE plan (D100/50/50), if enrolled – Vision: Default to no coverage – Flexible Spending Account (FSA): Election required each plan year – Health Savings Account (HSA): Election required each plan year

What’s News & What’s Changing for 2019-20 • BCBSM PPO2 Medical Plan – Increase annual deductible Current 2019-20 In-Network Out-Network In-Network Out-Network Single $400 $800 Single $500 $1,000 Family $800 $1,600 Family $1,000 $2,000 – Increase annual out-of-pocket maximum Current 2019-20 In-Network Out-Network In-Network Out-Network Single $1,600 $3,800 Single $2,000 $4,000 Family $3,200 $7,600 Family $4,000 $8,000 – Doctor office visit & urgent care copay increasing $10 ($20 to $30 per visit) • No changes to the Advantage HDHP and PPO1 medical plans - Confidential - 4

What’s News & What’s Changing for 2019-20 • CVS / Caremark Prescription Coverage (PPO 1 / PPO2) – Adopt Advanced Control Specialty Formulary in an effort to control the rising cost of specialty drugs – If you are impacted by this change, CVS / Caremark will contact you and your doctor directly • Coverage Enhancements: Designed to align with our continued efforts and support of a Culture of Health – CVS Caremark Prescription Plan (PPO1 / PPO2): 0% copay for preventive medication on the generic drug list – Dental Core & Buy Up Plans: Preventive Advantage benefit – all preventive care, incl. exams, cleaning, x-rays and fluoride treatment cost WILL NOT be deducted from annual benefit maximum

What’s News & What’s Changing for 2019-20 • Health Care Flexible Spending Account (FSA) – Increase annual contribution limit from $2,650 to $2,700 – Rollover Rule Update: Add a $25 minimum rollover balance • Health Savings Account (BCBS Advantage HDHP Participants) – University HSA contributions will continue for 2019-20 benefit year Single Coverage: $107.16 annual contribution » Two Person Coverage: $221.88 annual contribution » Family Coverage: $271.32 annual contribution »

What’s the Best Plan for You? All Your BCBSM Medical Options Provide: • In-network preventive care that’s free to you • The same provider network • Coverage for the same eligible expenses The Only Difference: How and How Much You Pay Premium Cost Share Out-of-Pocket Costs (deducted from your pay) (deductible, coinsurance, copays) A fixed cost, no matter how much or how Varies by the amount of care you need • little you use the plan Capped by your out-of-pocket • maximum - Confidential - 7

Medical / Prescription Monthly & Annual Costs Comparing Medical / Prescription Plan Options Medical / Prescription Plan Options Advantage HDHP PPO2 PPO1 97.5% CMU 91.7% CMU 82.6% CMU Premium Cost Share 2.5% Employee 8.3% Employee 17.4% Employee Employee Single $13.78 $ 49.46 $115.52 MONTHLY 2-Person $28.53 $102.38 $239.11 Cost Share Family $34.87 $125.14 $292.26 Single $107.16 University ANNUAL 2-Person $221.88 Not Available Not Available HSA Contribution Family $271.32 Benefit Summary: In-network benefits Medical Network BCBS BCBS BCBS Prescription Network BCBS CVS Caremark CVS Caremark Preventive care $0 (plan pays 100%) $0 (plan pays 100%) $0 (plan pays 100%) $1,350 member $500 member $200 member Annual deductible (7/1-6/30) $2,700 family** $1,000 family $400 family Coinsurance None 20% after deductible None Office visit (primary, specialist, $0 after deductible $30 copay $20 copay chiropractic) Urgent care visit $0 after deductible $30 copay $20 copay Emergency room visit $0 after deductible $100 copay $100 copay 10%/20%/30% Prescription 10%/20%/30% 10%/20%/30% after deductible Annual out-of-pocket maximum $3,350 member $4,000 member $2,800 member (medical & prescription combined ) $6,700 family $8,000 family $5,600 family **The full family deductible must be met under a two-person or family contract before benefits are paid for any person on the contract. This benefit summary is intended for use only as a source of reference. Official benefits, conditions, exclusions, and limitations are documented in the certificate and amendments.

Advantage HDHP vs. PPO2 Claim Example 2 • Maggie is single and injures her hip on a ski vacation. The injury requires surgery. The costs associated with her procedure total $60,000. Maggie also has 6 monthly follow-up visits with her orthopedic specialist for check-ups on her injury. What does Maggie pay? Advantage HDHP Plan PPO Plan Deductible $1,350.00 Deductible $ 500.00 Coinsurance Coinsurance (0% to OOPM) $0 (20% to OOPM) $1,500.00 Office Visits $0 Office Visits $ 0 Maggie’s Cost* $1,350.00 Maggie’s Cost* $2,000.00 CMU HSA Contribution ($ 107.16) Maggie’s Premium Cost $ 593.52 Maggie’s Premium Cost $ 165.36 Maggie’s Total Cost $2,593.52 Maggie’s Total Cost $1,408.20 *Libby could also use additional pre-tax health care FSA funds to pay the claims costs Maggie could also use her own additional pre-tax HSA funds to pay the claims cost. 9

Advantage HDHP vs. PPO2 Claim Example 2 • Libby is married and has 4 kids. During the year, they had 6 visits to the pediatrician ($175 each) and had to fill 9 preferred brand name prescriptions ($100 each). She and her husband Jack went to the doctor 4 times during the year. How much did they spend during the year? Advantage HDHP Plan PPO2 Plan 6 x $175 Office Visit $1,050.00 6 x $30 OV copay $180.00 Tier 2 Rx (9 x $100) $ 900.00 Tier 2 Rx (9 x $20) $180.00 4 x Online Visit (4 x $49) $ 196.00 4 x Online Visit (4 x $5) $ 20.00 Libby’s Cost* $2,146.00 Libby’s Cost* $ 380.00 VU HSA Contribution ($ 271.32) Libby’s Premium Cost * $1,501.68 Libby’s Premium Cost $ 418.44 Libby’s Total Cost $1,881.68 Libby’s Total Cost $2,293.12 *Libby could also use additional pre-tax health care FSA funds to *Libby could also use additional pre-tax HSA funds to pay the pay the claims costs claims cost.

Know Where to Go Know where to go when you need medical care and receive the best treatment with the lowest out-of- pocket costs.

Blue Cross Online Visits Online Visits allows you to have face-to-face • conversations with a doctor on your computer or mobile device It’s especially convenient on nights and weekends • when your doctor’s office or urgent care isn’t open Provides access to in-network, board-certified • doctors and licensed behavioral health professionals Allows doctors to ePrescribe utilizing local • pharmacies (where applicable) Costs $5 copay (for PPO1/PPO2) and $49 (for • Advantage HDHP) for an online doctor visit To get started, visit www.bcbsmonlinevisits.com or • call 844-606-1608

CMU Primary Health Care Services • Health care services includes: – Routine care and physicals – Acute and chronic illness management – Allergy injections and immunizations – Gynecological exams – Basic cardiac screening – Sports medicine – Cosmetic services – Full service lab testing • Same-day appointment and walk-in availability • Clinic services can be billed to your BCBSM or MESSA insurance • Schedule appointments by phone: 989-774-7585 13

C.H.I.P. Injury Rehabilitation Services • C.H.I.P. rehabilitation services include: – Rehabilitation of musculoskeletal injuries (e.g. sprains, strains, contusions, spasms) – Pre- and post-operative injuries – Conditioning & long-term maintenance programs for chronic injuries – Some of the treatments available include: ice packs, heat packs, ultrasound, electronic muscle stimulation, Acuscope/Myopulse, stretches, resistive exercises, range of motion exercises, and warm and cold whirlpool • No cost for regular full-time and part-time employees, spouses / OEIs and dependents 16 years of age and older • Hours are Monday – Friday from 8am – noon and 1pm – 5pm • A prescription is required for treatment • Schedule appointments by phone: 989-774-3198 14

What’s News & What’s Changing for 2019-20 • New claims administrator: • Dental plan options remain the same plans: Core (100-50-50) Plan and Buy-Up (100-75-50-50) Plan • No longer a passive PPO network – Dental providers are either in-network or out-of-network – Out-of-network claims will be processed at 100% UCR – To find an in-network dentist, go to www.guardiananytime.com and click “Find a Provider” in the upper navigation • New ID cards will be mailed to employee’s home in the middle of June - Confidential - 15