Health & Welfare Employee Benefits 2015 Benefits Overview - PowerPoint PPT Presentation

Health & Welfare Employee Benefits 2015 Benefits Overview

AGENDA  Benefits Team  Benefits Overview  Benefits Enrollment  New Hire Benefits Action Checklist  Tools and Resources  Q&A 1:30pm-2:30pm  Benefits New Employee Orientation presentation: HealthySteps > Life Events > New Hire (Resources Box): 2015 NEO Benefits Presentation Confidential – For Discussion Purposes Only 2

BENEFITS TEAM  Stanford Health Care (SHC) Benefits Team − Responsible for design and delivery of SHC employee Health & Welfare, Retirement, and other Voluntary benefit plans and programs − Manage and partner with multiple vendors to ensure outstanding delivery of contracted services  HealthySteps – benefits website: www.healthysteps4u.org − Main hub for benefits and wellness program information, Benefitsolver Link, Plan Details, Summary Plan Descriptions and Booklets, Newsletters, Events, Holiday Schedule, Vendor Contacts , NEO Benefits PPT, etc.  Businessolver – benefits system administrator: Benefitsolver  Benefitsolver: www.benefitsolver.com − Benefits enrollment portal and the Service Center Team − Assist with benefits enrollment and/or changes, answer benefits questions, process Dependent Verification (Phone, Email, or Live Chat – assist in most languages)  Other Benefits Partners and Vendors − Extension of SHC Benefits Department who help administer benefit plans and programs − Experts in the field who will help you navigate through plan details Confidential – For Discussion Purposes Only 3

HEALTHYSTEPS: Benefits Website Home Page Confidential – For Discussion Purposes Only 4

ELIGIBILITY  Who’s Eligible? − Employees scheduled to work at least 40 hours per pay period (0.5 FTE)  Eligible Dependents (Dependent Verification) − Spouse (SP): Same- or Opposite-Sex − Eligible Domestic Partner (EDP): Same-Sex or Opposite-Sex if you or your partner is age 62+ − Eligible Children up to age 26 (age 23 for Child Life Insurance)  No Double Coverage at SHC − Spouse/EDP is an employee of SHC or Stanford Children’s Health network, e.g. LPCH, PCHA − Enroll as an Employee or a Dependent but not BOTH ( Waive Spouse Life Insurance ) − Only one parent may cover Eligible Dependent Children for Medical/Vision Plan and Child Life Insurance − Dual coverage is allowed in Dental Plan for Eligible Dependent Children  Working Spouse Access Fee (WSAF): $25/Paycheck fee if all criteria are met − SP/EDP is offered health coverage from his/her employer, declines coverage, and enrolls in an SHC-Medical Plan; and you earn $30.76 or more per hour − Not applicable if SP/EDP works for SHC, LPCH, or PCHA  Cost-Sharing of Benefit Plans (24 semi-monthly Paycheck Deductions) − SHC shares most of the health plans cost and some benefit plans are provided by SHC at no cost to you Reference: HealthySteps > HELP > Benefits Handbook > SPD Booklets: Booklet A Confidential – For Discussion Purposes Only 5

HEALTH BENEFITS: Medical/Vision Plans  3 Medical Plan options: SHCA, PPO with HSA, Kaiser HMO Permanente − Vision Plan (Administered by VSP) is covered when enrolled in a medical plan − Preventive Care covered at 100% − Stanford Coordinated Care (SCC) program is available to SHCA and PPO Plan participants Reference: HealthySteps > Health & Welfare Benefits > Medical / Vision  Stanford Health Care Alliance – Administered by Blue Shield of California − SHC’s own health care plan introduced in 2014; must use SHCA network of providers and facilities; California Bay Area coverage; 1 Medical Card − Encouraged to designate a PCP or will be assigned to ClickWell Care  PPO with HSA – Administered by UMR | Mental Health by Optum | Prescription by Express Scripts − High deductible health plan, flexibility of going in- and out-of-network; Health Savings Account (HSA)-qualified; 3 tiers of network (2 tiers for CRONA); 1 Medical Card/1 Prescription Card  Kaiser Permanente HMO – Administered by Kaiser Permanente − must use Kaiser network of providers and facilities; Northern California coverage; Copays and Coinsurance applies (different for CRONA); 1 Medical Card Confidential – For Discussion Purposes Only 6

HEALTH BENEFITS: Choosing a Medical Plan Kaiser COMPARI NG MEDI CAL SHCA PPO w ith HSA Perm anente FEATURES HMO See any provider you’d like, I n-  or Out-of-Netw ork Must use in-netw ork providers   and facilities Access to three tiers of  providers and facilities (For CRONA, 2 Tiers) Low -Cost Prem ium s or free in    som e instances ( refer to Rate Sheet) Set Copays established for   services Health Savings Account ( HSA) -  FSA FSA Eligible Free Preventive Care    W ellness incentive funds HSA   deposited into Health I ncentive (Except if ineligible for HSA) Account ( HI A) W ellness incentive funds  deposited into Health Savings Account ( HSA) Urgent Care &  Out-of-State Dependents Em ergency Services Em ergency Services $400 / $1,000 $1,300 / $2,600 $400 / $1,000 Annual Deductible $EE / $EE+ + ( CRONA: Refer to Booklet) (In-Network Amounts Only) Annual Out-of-Pocket Max $1,800 / $3,600 $2,600 / $5,200 $1,800 / $3,600 Confidential – For Discussion Purposes Only 7

HEALTH BENEFITS: Dental Plans  2 Dental Plan Options: Delta Dental PPO, DeltaCare USA DHMO Reference: HealthySteps > Health & Welfare Benefits > Dental  Delta Dental PPO – Administered by Delta Dental − Flexible, in- and out-of-network − Employee semi-monthly premiums apply on ES and EF coverage − Orthodontia covers up to age 26, EE and CH only − No Dental Card issued  DeltaCare USA DHMO – Administered by Delta Dental − Select a Primary Care Dentist from DeltaCare USA network, CA only − No Employee semi-monthly premiums − Covers Adult Orthodontia Confidential – For Discussion Purposes Only 9

HEALTH BENEFITS: Tax-Advantage Accounts HSA / FSA  Health Savings Account (HSA) and Flexible Spending Accounts (FSA) – Administered by HealthEquity Reference: HealthySteps > Health & Welfare Benefits > HSA/FSA/HIA Resources: IRS Publication 969 – HSA / IRS Publication 502 – Medical & Dental Expenses / IRS Publication 503 – Child & Dependent Care Expenses − Tax-advantaged accounts that allow you to use pre-tax $ to pay for IRS-qualified health care and/or dependent daycare expenses − Any earned SHC contributions will count towards Annual Max Limit − Must be an active Employee at the time earned SHC funds are deposited to HSA/HIA or will be forfeited  Health Incentive Account – Administered by HealthEquity − Health Reimbursement Account funded by wellness incentive dollars based on eligibility and participation in the HealthySteps to Wellness program − Employer-funded, No Employee contributions − Enrolled in the SHCA or Kaiser, or in PPO Plan but not eligible for an HSA − Same rules as Health Care FSA − No Debit Card, claims reimbursement Confidential – For Discussion Purposes Only 10

HEALTH BENEFITS: Tax-Advantage Accounts Health Savings Account (HSA) Flexible Spending Accounts (FSA) • Savings and spending account to • Health Care 2015 IRS Max Limit: use now and into retirement $ 2 ,5 0 0 / Dependent Care (Daycare) 2015 IRS Max Limnit: • 2015 IRS Max Limit: $ 3 ,3 5 0 / EE $ 5 ,0 0 0 (per household) or $ 6 ,6 5 0 / EE+ + ($1,000 catch- up age 55+ ) • SHCA or Kaiser Plan participants, or if ineligible for HSA • PPO Plan participants (except if ineligible for HSA) • Use it or Lose it! • Employee-owned, portable, rolls • Expenses must be incurred by over from year-to-year 12/ 31/ 2015 and submit all claims by 3/ 15/ 201 • Update contributions any time in Benefitsolver • Annual elections can be changed only during Annual OE or QLE • Debit Card • Debit Card for HCFSA / No Debit • Re-elect during Annual OE Card for DCFSA, claims reimbursement • Re-elect during Annual OE Confidential – For Discussion Purposes Only 11

HEALTH BENEFITS: Wellness, EAP, CareCounsel  HealtySteps to Wellness Program – Administered by Stanford Wellness Team Reference: HealthySteps > Health & Welfare Benefits > Employee Assistance Program  Employee Assistance Program (EAP) – Administered by ValueOptions Reference: HealthySteps > Health & Welfare Benefits > Employee Assistance Program − SHC-provided at no cost to you, effective DOH − Work-life resources such as counseling, education, referrals − 10 free sessions per issue per year  CareCounsel – health advocacy benefit Reference: HealthySteps > Health & Welfare Benefits > Medical > CareCounsel − SHC-provided at no cost to you, effective DOH − Help you understand your health benefits and how to use your plans, claims resolution, understanding Medicare, help understand prescription drug formularies, etc. Confidential – For Discussion Purposes Only 12