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Employee Benefits Open Enrollment 2016 Agenda Employee Benefits - PowerPoint PPT Presentation

Employee Benefits Open Enrollment 2016 Agenda Employee Benefits Update 2016 Medical Plans 2016 Ancillary Benefit Plans Additional Benefits Next Steps 2 Healthcare Cost Management What is exp doing to help manage


  1. Employee Benefits Open Enrollment 2016

  2. Agenda Employee Benefits Update � 2016 Medical Plans � 2016 Ancillary Benefit Plans � Additional Benefits � Next Steps � 2

  3. Healthcare Cost Management What is exp doing to help manage rising healthcare costs? � Exp has designed a program that provides a comprehensive level of benefits that promotes wellness and offers choices to our employees � Exp currently pays a large portion of health care coverage premiums for eligible employees and dependents � Exp offers tools and incentives to empower members to be responsible healthcare consumers 3

  4. 2016 Open Enrollment There will be no changes in the benefit plans. � Exp will continue to offer Medical/Rx plans; administered by UnitedHealthcare. � Payroll deductions will increase slightly = 5% � Exp will continue to offer Dental, Vision, Life and AD&D, Short-term and Long-term Disability; administered by Guardian. 4

  5. What Can You Do? � Become better healthcare consumers � Be proactive with your health – get your annual exams and preventive screenings � Go to your doctor or a convenience care clinic when ill; don’t wait � Complete an online Health Risk Assessment � Use urgent care for non-emergencies instead of the emergency room � Use generic medications when possible � Follow Rx dosage instructions 5

  6. 2016 Benefit Overview Carrier Coverage UnitedHealthcare Medical, Prescription Drugs Guardian Dental, Vision, Life and AD&D, Short- term and Long-term Disability Trustmark Accident and Critical Illness Plans Allstate Cancer Plans myCafeteriaPlan Flexible Spending Accounts and Health Reimbursement Accounts Health Advocate Assists employees and families navigate the healthcare system Guardian Employee Assistance Program 6

  7. UnitedHealthcare Medical Options Medical Plan � All of the plans will remain the same for 2016. � UnitedHealthcare will continue to be the national insurance carrier for exp, with the exception of employees in Alaska. � You will have 3 options to choose from: � The Choice Plan offers in-network benefits with co-pays at the physician’s office and pharmacy. � The Choice Plus Plan offers in and out-of-network benefits with co- pays at the physician’s office and pharmacy. � The HRA Plan is a high deductible in-network only health plan that offers a Health Reimbursement Account. � Preventive is covered at 100% with no co-pays on all plans. 7

  8. CHOICE PLAN TYPE OF SERVICE YOU PAY: � Primary Care/Specialist office visit: $15/$40 � Virtual Visit **NEW** $25 � In-patient hospital care: 20% after deductible � Out-patient hospital care: 20% after deductible � Emergency room: $250 (any ER) � Urgent Care: $75 � Lab and x-ray: Covered in full � Scans and Therapies 20% after deductible � Deductible (Individual/Family) $750/$1,500 per year � Out-of-Pocket (includes deductible) $3,750/$7,500 per year � Lifetime Maximum Unlimited � Prescription Drugs (Retail) $10 Tier 1/$35 Tier 2/$70 Tier 3 � Mail Order (90 day supply) 2.5x Retail 8

  9. CHOICE PLUS PLAN TYPE OF SERVICE YOU PAY: � Primary Care/Specialist office visit: $15/$40 � Virtual Visit **NEW** $15 � In-patient hospital care 20% after deductible � Out-patient hospital care 20% after deductible � Emergency room $250 (any ER) � Urgent Care $75 � Lab and x-ray 100% covered � Scans and Therapies 20% after deductible � Deductible (Individual/Family) $500/$1,000 in-network; $2,000/$4,000 out-of-network � Out-of-Pocket (includes deductible) $3,500/$7,000 in-network; $5,000/$10,000 out-of-network � Lifetime Maximum Unlimited � Prescription Drug(Retail) $10 Tier 1/$35 Tier 2/$70 Tier 3 � Mail Order (90 day supply) 2.5x Retail � Out of network coinsurance 40% after deductible 9

  10. CHOICE HRA PLAN TYPE OF SERVICE YOU PAY: � Primary Care/Specialist office visit: $25/$50 � Virtual Visit **NEW** $25 � In-patient hospital care: 20% after deductible � Out-patient hospital care: 20% after deductible � Emergency room: $250(any ER) � Urgent Care: $75 � Lab and x-ray: Covered in full � Scans and Therapies: 20% after deductible � Deductible (Individual/Family) $2,000/$4,000 � Out-of-Pocket Maximum (includes deductible) $4,500/$9,000 � Lifetime Maximum Unlimited � Prescription Drugs (Retail) $10 Tier 1/$35 Tier/ $70 Tier 3 � Mail Order (90 day supply) 2.5x Retail 10

  11. Health Reimbursement Account � Exp is offering employees a Health Reimbursement Account (HRA) on the high deductible plan option only to help offset the costs associated with out of pocket expenses. � The company will be adding an annual contribution of $500 automatically to your HRA on January 1. You can use this money for co-pays, deductibles, or other out of pocket costs associated with qualified medical, dental, or vision expenses. You will receive a debit card to access the money. � You are able to earn an additional $500 one time contribution into your HRA fund. Each employee that completes an on-line Health Risk Assessment will be eligible for an additional $500 contribution to the HRA. � Spouses and dependents can use Health Reimbursement Account (HRA) funds only if they are enrolled in a health plan that meets the minimum standards of the ACA (either with exp or elsewhere). Spouses and dependents with no proper health insurance coverage will not qualify for HRA use. � HRA funds do not roll-over into next plan year. Unused HRA funds will be forfeited at the end of the plan year. � If you elect the Healthcare FSA also, your HRA funds will be used first. 11

  12. Health Risk Assessment � A Health Risk Assessment provides you with an individual wellness score that measures your overall health, will take about 20 minutes to complete, and includes 50 standard lifestyle questions. � The Assessment is confidential, and you only need to complete the Assessment, not achieve a certain score. � To start the Health Risk Assessment, you will need to set up an account at www.myuhc.com. w.myuhc.com � No need to submit proof upon completion, balances to the HRA will automatically be credited the additional $500 on a monthly 12 basis.

  13. Scans and Therapies � Scans and Therapies are major diagnostic services such as MRI, CT Scan, PET Scan, MRA and Nuclear Medicine. � They are typically performed at a hospital or out-patient center, and sometimes in a doctor’s office. � They can cost several hundred dollars or more (if in- network, more if out-of-network.) � Use the Treatment Cost Estimator on myUHC.com to determine what your cost will be. � Regardless of where the test is done, the benefits are subject to Deductible, then Coinsurance, even if performed in a doctor’s office (“Covered” does not mean “Paid at 100%.”) ## 13

  14. Saving money on Prescriptions Mail Order Prescription Benefits: � You can order a 3 month supply of medicine to be shipped to you for only the cost of 2.5 co-pays. � This saves you time and money for medicines you take on a routine basis. Generic Medications: � Several pharmacies now offer special prescription programs, including $4 generic drugs and free antibiotics. � Generic drugs contain the same active ingredients and are available in the same strength and dosage form as their brand- name counterparts but could cost up to 50% less. 14

  15. myUHC.com Look up network doctors / � hospitals Estimate costs � Track claims status � Health improvement � program Personal Health Record � Health product discounts � Review plan details � 15

  16. Health Advocate Information & Service Support •Assist with eldercare issues Clinical Services •Obtain health information to help make •Find qualified healthcare providers informed decisions •Schedule appointments •Assist with finding qualified wellness •Locate and research the newest programs treatments •Help arrange transportation •Assist with complex medical condition •Assist with understanding test results Administrative Health Coaching Services •Obtain unbiased health information •Navigate within an insurance company •Help prepare patients for You will be •Assist with correcting billing healthcare appointments assigned a mistakes •Help members become active Personal participants in their healthcare Health Advocate (PHA ) � 24/7 Toll-free telephone support � Your privacy is protected 16

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