2020 BENEFITS OPEN ENROLLMENT Open Enrollment April 15 th , 2020 - PowerPoint PPT Presentation

ROCKFORD PUBLIC SCHOOLS 2020 BENEFITS OPEN ENROLLMENT

Open Enrollment  April 15 th , 2020 through April 30 th , 2020 (No later than 5:00pm)  Changes will take effect July 1, 2020 Allowed enrollment changes ◼ Choose Between Available Health Plans ◼ Make/Change Annual FSA Elections ◼ Elect/waive medical/dental coverage ◼ Add/remove dependents from medical/dental coverage ◼ Add voluntary term life insurance effective July 1, 2020

2 Health Plans Available  PPO1000  $1000 Individual Deductible  High Deductible Health Plan (HDHP)  $2500 Individual Deductible  Health Savings Account Component The PPO 3000 Plan Will Not Be Offered After July 1 st , 2020. Any Current PPO 3000 Plan Participants Who Do Not Log In and Make a Change Will Automatically be Enrolled onto the HDHP/H.S.A. Plan For July 1, 2020

Health Plan Design Options PPO Plan HDHP Plan Out of Out of Office Visits In Network Network In Network Network Primary Care $15 50% Ded./Coins. Ded./Coins. Specialist $25 50% Ded./Coins. Ded./Coins. Deductible Single $1,000 $1,000 $2,500 $5,000 Family $2,000 $3,000 $5,000 $10,000 Out of Pocket Max* Single $4,000 $8,000 $3,500 $7,000 Family $8,000 $16,000 $7,000 $14,000 Coinsurance 80% 50% 80% 50% Emergency Room $200 50% Ded./Coins. Ded./Coins. Enrolling in The High Deductible Health Plan (HDHP Plan) allows you to open a Health Savings Account (HSA) *Out of Pocket Maximum Includes Deductible

What is a Health Savings Account (H.S.A.)  A tax-preferred method for funding uninsured medical expenses  Unused funds do rollover and are kept by the employee. USE IT OR KEEP IT  “Portability” Can be rolled over into another H.S.A.. “The healthcare equivalent of the 403b”  Can be cashed out but will be subject to income tax plus a 20% penalty (if < Age 65)

What is a Health Savings Account (H.S.A.) cont …  H.S.A. accounts enjoy a triple tax advantage:  Pre-tax dollars going into the account  Interest earned is NOT taxed  In general, distributions used for medical/dental/vision claims or certain plan premiums are also NOT taxed  This is an account that belongs to the employee regardless of who contributes and is put into an Associated Bank account with a debit card.

With tax advantages come IRS rules

HSA Eligibility The $2,500 deductible option is a Anyone who is: qualified HDHP • Covered by a “qualifying” HDHP • Not covered by other health insurance (unless it is also a “qualifying” HDHP) – Doesn’t apply to specific injury insurance, accident, disability, dental, vision, long-term care – Includes spouse’s plan or a retirement health plan • Not enrolled in Medicare or Medicaid

Contributions/Distributions?

Contributions for Accounts  Employer and/or employee can contribute to an H.S.A.  You can make contributions via payroll similar to the FSA. Even better, you can change/vary your contributions during the year.  Maximum contribution for 2020 is limited to $3,550 single / $7,100 family .  Allowable “Catch Up ” contributions for American’s 55 years and older of $1,000/yr

Contributions for Accounts  Rollover from an another H.S.A is allowed .  Additional contributions can be made on your own and are written off on personal taxes as an “above line deduction”  You have up until April 15 th of the following year to contribute for the current year

H.S.A. Distributions  Pays for qualified medical expenses under Section 213(d)  Traditional PPO medical expenses AND expenses such as dental, vision, etc.  Includes expenses incurred due to COVID19  Spouse or dependent medical expenses eligible – even if not covered on your plan  H.S.A contributions can also be used for:  COBRA premiums  Long-term care coverage  CASH! Subject to taxes and a 20% penalty <Age 65

On to the High-Deductible Plan or HDHP

High Deductible Health Plan Basics  Based on same BCBS PPO Network  Pharmacy Network will be Prime Therapeutics  Major differences to traditional PPO:  Higher deductible  Actual costs of your medical expenses (after BlueCross discounts) are subject to this high deductible such as doctor office visits, lab, x-ray, hospital, surgery, Emergency Room, and prescription drugs…etc. Concept of Copay is removed .  Preventative care is NOT subject to the deductible and is covered at 100% in-network at a $0 Copay.

HDHP and H.S.A. Funding - How do they work together to pay your medical expenses?

RPS Annual HSA Funding Single Employee Plus Employee Plus Family Spouse Child(ren) Standard $400 $700 $600 $800 Wellness $250 $500 $550 $700 Total (W) $650 $1200 $1150 $1500 • Amounts are made available on the first day of the new plan year • Those enrolling in the $2,500 HDHP will need to complete an application for an HSA account with Associated Bank. • RPS will transfer the amounts below into your Associate HSA bank account based on medical enrollment status

Day To Day Workings Of An H.S.A.

Claims – How To Use  Just like today, always show your medical ID card  Whenever possible especially In Network – DON’T pay up front – BlueCross (BCBS) and Associated Bank (bank) are 2 separate companies  Provider will send claim to BCBS so they can apply the discount  Once you receive the Explanation of Benefits (EOB), it will show you what you owe the provider which you may then pay from your H.S.A. Bank Account with your Associated debit card  Pharmacy already has discounts in their system at the time of purchase. Can use Associated Bank debit card.

H.S.A Savings Opportunity Upfront Savings Annual PPO H.S.A Contrib. + by Choosing the Paycheck Cost Premium Costs H.S.A* Single $606 $650 $1,256 Money You EE + Spouse $2,319 $1,200 $3,519 Keep if you have no claims EE + Child(ren) $2,181 $1,150 $3,331 Family $3,354 $1,500 $4,854 *Before claims are taken into account The number listed in the green box represent the amount of money you save in paycheck contributions plus the dollars the district will put in your H.S.A. account if you choose the HDHP plan.

Preventive Care, Prescription Drugs, and Wellness: PPO vs HSA

Preventive Care – All Plans • In Network - 100% covered with no cost sharing (not subject to deductible) • Out of network – 50% covered (not subject to deductible) • Preventative services include but are not limited to: • Adults: Cholesterol screening, immunizations, mammography, pap smear, colonoscopy, routine annual physical • Children: Immunizations, routine annual physical Preventive Care is Subject to Federal Guidelines as Laid Out by HHS Including Age and Frequency Limits.

Prescription Coverage - Express-Scripts Tier PPO1000* HDHP Tier 1 $15 Ded./Coins. Tier 2 $40 Ded./Coins. Tier 3 $60 Ded./Coins. Mail Order 2x’s for 90 days Ded./Coins. * Prescriptions filled at Walgreens and CVS will cost an additional $10 . • Mail order for maintenance drugs is mandatory after 3 fills at the local pharmacy. • Can access information on-line to: www.express-scripts.com • Check whether medication is covered. • Compare mail order vs pharmacy cost. • Check for generic equivalent or formulary alternatives.

Prescription Co-pays • Can use most independent Pharmacies • Prescriptions purchased at CVS or Walgreens (PPO only) will cost an additional $10 each. • Possible less expensive alternatives: • Wal-Mart • Meijer • Sam’s Club Mail order for maintenance drugs is mandatory. 90-day supply through mail order vs. 30-day supply at local pharmacy.

Claim Example: No Claims- Single Coverage HDHP Plan 1000 PPO PLAN Annual Pay Check Contribution $-606 (Annual Cost to Employees) $+650 (Given by RPS) Plus District H.S.A Contribution Including Wellness Incentive Claims Cost No Claims Costs No Claims Cost Total Plan Cost You Pay $606 $650 That You Keep! HDHP Saves $1,256 * H.S.A Dollars Based on Participating in Wellness Program

Claim Example: $1,500 In Medical Claims – Single Coverage. HDHP Plan 1000 PPO PLAN Annual Pay Check Contribution $-606 (Annual Cost to Employees) $+650 (Given by RPS) Plus District H.S.A Contribution Including Wellness Incentive $1000 Deductible Cost After $850 HDHP Contributions $100 $0 Coinsurance Total Plan Cost $1706 $850 Including Paycheck Contrib. HDHP Saved $856 * H.S.A Dollars Based on Participating in Wellness Program

Claim Example: $15,000 In Medical Claims – Single Coverage. HDHP Plan 1000 PPO PLAN Annual Pay Check Contribution $-606 $+650 (Given by RPS) Plus District H.S.A Contribution Including Wellness Incentive $1000 $1850 Deductible Cost $3000 $1000 Coinsurance Total Plan Cost $4566 $2850 Including Paycheck Contrib. HDHP Saved $1716 * H.S.A Dollars Based on Participating in Wellness Program

H.S.A. – Other tips  Timing of claims  You can only spend what you have  RPS will front load your annual fund of $400 single / $800 family in month one. (Plus any additional wellness funds for which you qualify)  Should funds not be immediately available you may s be able to set up payment plan with your medical provider  Advise maintaining an H.S.A. envelope for receipts, EOB’s, account information. (May be required if audited by the IRS) Responsibility is all yours!