Medical Plan Comparison Central Care Plan Medical / Prescription - PowerPoint PPT Presentation

Medical Plan Comparison Central Care Plan

Medical / Prescription Benefit Summary Advantage HDHP/HSA Plan PPO 2 Plan PPO 1 Plan PLAN OPTIONS In ‐ Network In ‐ Network In ‐ Network MEDICAL PLAN BCBS BCBS BCBS $1,300 Single* $250 Single $100 Single Annual Deductible (7/1 ‐ 6/30) $2,600 Family* $500 Family $200 Family Coinsurance (After Deductible) 100% Plan / 0% Member 80% Plan / 20% Member 100% Plan / 0% Member Office Visit Copay $0 after deductible $20 Copay $20 Copay Urgent Care Copay $0 after deductible $20 Copay $20 Copay ER Copay $0 after deductible $75 Copay $75 Copay Preventive Care $0 (Plan pays 100%, no deductible/copay) $0 (Plan pays 100%, no deductible/copay) $0 (Plan pays 100%, no deductible/copay) $0 Single $1,000 Single $500 Single Coinsurance / Copay Maximum $0 Family $2,000 Family $1,000 Family HDHP Deductible includes medical and Rx costs Medical Out ‐ of ‐ Pocket Maximum $1,300 Single $1,250 Single $600 Single (7/1 ‐ 6/30) $2,600 Family $2,500 Family $1,200 Family PRESCRIPTION PLAN BCBS CVS Caremark CVS Caremark Copay applies after deductible N/A Deductible N/A Generic 10% Copay 10% Copay 10% Copay Formulary 20% Copay 20% Copay 20% Copay Non ‐ Formulary 30% Copay 30% Copay 30% Copay Prescription Out ‐ of ‐ Pocket $2,000 Single (after deductible) $2,000 Single $2,000 Single Maximum $4,000 Family (after deductible) $4,000 Family $4,000 Family TOTAL MEDICAL $3,300 Single $3,250 Single $2,600 Single + Rx OUT ‐ OF ‐ POCKET MAXIMUM $6,600 Family $6,500 Family $5,200 Family (7/1 ‐ 6/30) *The full family deductible must be met under a 2 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.

Medical / Prescription Monthly & Annual Costs Advantage HDHP/HSA Plan PPO 2 Plan PPO 1 Plan PLAN OPTIONS In ‐ Network In ‐ Network In ‐ Network FULL ‐ TIME EMPLOYEE PREMIUM COST SHARE Monthly Cost Share Amount Single $23.88 $0.00 $78.29 2 ‐ Person $49.42 $0.00 $162.05 Family $60.41 $0.00 $198.07 Annual Cost Share Amount Single $286.56 $0.00 $939.48 2 ‐ Person $593.04 $0.00 $1,944.60 Family $724.92 $0.00 $2,376.84 2016 ‐ 2017 Plan Year CMU HSA Contribution Monthly HSA Contribution Single: $70.29 Two Person: $145.48 Family: $177.80 Annual HSA Contribution Single: $843.48 Two Person: $1,745.76 Family: $2,133.60 University contributions are depostied into employee's HSA each pay period.

Total Must Pay and Might Pay Side ‐ By ‐ Side Comparison – Employee Only (Annual) Total Maximum Annual EE Cost of HDHP w/HSA, including CMU HSA Total Maximum $4,000 Contribution of $843, Annual EE Cost of PPO EE Only Option = Total Maximum 1, EE Only Option = *$2,744 Annual EE Cost of PPO $3,539 2, EE Only Option = $3,500 $3,250 Prescription Might Pay (coinsurance maximum $3,000 $2,000 in for prescription plan) prescription copay *$2,744 maximum $2,000 in $2,500 prescription copay *Net of CMU $2,000 in HSA maximum prescription copay Medical Might Pay Contribution maximum (meeting deductibles and $2,000 coinsurance maximum for medical plan) $1,500 Must Pay (full ‐ time $600 in medical employee annual deductible & copay $1,300 in medical + maximum contribution) $1,000 prescription deductible $1,250 in medical deductible, $939 employee $500 coinsurance & copay payroll contribution maximum $287 employee payroll contribution $0 HDHP w/HSA CMU PPO 2 CMU PPO 1 Exhibit assumes in ‐ network usage and is provided for illustrative purposes only.

Total Must Pay and Might Pay Side ‐ By ‐ Side Comparison – Two Person (Annual) Total Maximum Annual EE Cost of HDHP w/HSA, including CMU HSA Total Maximum $8,000 Contribution of Annual EE Cost of PPO $1,746, EE+1 Option = Total Maximum 1, EE+1 Option = *$5,447 Annual EE Cost of PPO $7,145 2, EE+1 Option = $7,000 $6,500 Prescription Might Pay (coinsurance maximum $6,000 $4,000 in for prescription plan) prescription copay *$5,447 maximum $4,000 in $5,000 prescription copay *Net of CMU $4,000 in HSA maximum prescription copay Medical Might Pay Contribution maximum (meeting deductibles and $4,000 coinsurance maximum for medical plan) $3,000 Must Pay (full ‐ time $1,200 in medical employee annual deductible & copay $2,600 in medical + maximum contribution) $2,000 prescription deductible $2,500 in medical deductible, $1,945 employee $1,000 coinsurance & copay payroll contribution maximum $593 employee payroll contribution $0 HDHP w/HSA CMU PPO 2 CMU PPO 1 Exhibit assumes in ‐ network usage and is provided for illustrative purposes only.

Total Must Pay and Might Pay Side ‐ By ‐ Side Comparison – Family (Annual) Total Maximum Annual EE Cost of HDHP w/HSA, Total Maximum including CMU HSA Annual EE Cost of PPO Contribution of $2,134, 1, Family Option = $8,000 Family Option= $7,577 Total Maximum *$5,191 Annual EE Cost of PPO 2, Family Option = $7,000 $6,500 Prescription Might Pay (coinsurance maximum $6,000 $4,000 in for prescription plan) prescription copay *$5,191 maximum $4,000 in $5,000 prescription copay *Net of CMU $4,000 in HSA maximum prescription copay Medical Might Pay Contribution maximum (meeting deductibles and $4,000 coinsurance maximum for medical plan) $1,200 in medical $3,000 deductible & copay Must Pay (full ‐ time maximum employee annual $2,600 in medical + contribution) $2,000 prescription deductible $2,500 in medical deductible, $2,377 employee $1,000 coinsurance & copay payroll contribution maximum $725 employee payroll contribution $0 HDHP w/HSA CMU PPO 2 CMU PPO 1 Exhibit assumes in ‐ network usage and is provided for illustrative purposes only.

Health Savings Account (HSA) HSAs are individually ‐ owned bank accounts • – The account belongs to you so only you can decide how to spend it Both you and your employer can contribute funds – – Money left in your account carries over from year to year – It remains yours even if you leave the university or retire • HSAs are used to help pay for both current and/or future health care expenses – You can withdraw money tax ‐ free for qualified health expenses (non ‐ qualified expenses are subject to taxes and penalties) – Or you can save funds to pay for future expenses • A HSA is triple tax ‐ advantaged – Contributes are made pre ‐ tax and funds can grow tax free and withdrawals for qualified health expenses tax ‐ free • Who is eligible for an HSA? Anyone who is: Covered by a qualified high deductible health plan (HDHP) – – Not enrolled in Medicare – Not covered under other health insurance coverage, including a spouse’s plan (unless a qualified HDHP) – Not another person’s tax dependent More information, visit www.treas.gov and click on Health Savings Account (HSA)

Triple Tax Savings Money Can Be Used Tax Free Money Money Is Grows Tax Yours To Free Keep! Money Goes In Tax Free Total Annual Age 55+ Annual Annual Coverage HSA Contribution Employer HSA Employee HSA Level Contribution “Catch ‐ Up” – Contribution Contribution Maximum Per Person Single $843.48 $2,506.52 $3,350 $1,000 Two Person $1,745.76 $5,004.24 $6,750 $1,000 Family $2,133.60 $4,616.40 $6,750 $1,000

How to use your HSA at the Doctor’s Office Go to Doctor and present your Blue Cross Blue Shield Medical ID card and receive services. Note – you should not pay anything at the time of service . Doctor submits claims to Blue Cross Blue Shield If services are not billed as preventive, discounted If services are billed as preventive, office charges will be applied to your deductible/out-of- visit will be covered at 100% pocket maximum You will receive an Explanation of Benefits (EOB) in the mail outlining the charges you are responsible for. Your doctor will bill you directly for any charges. You will use your HSA debit card, or other method of payment to pay your doctor the charges you are responsible for

How to use your HSA at the Pharmacy Obtain the Prescription / Rx from your Doctor Go to pharmacy of your choice and present your Blue Cross Blue Shield Medical ID card Use your HSA debit card or checkbook to pay for the discounted cost of the drug at the point of sale. Save your receipt for tax purposes. The pharmacy’s system will submit your claim electronically to Blue Cross Blue Shield to apply the charges towards your deductible/ out-of-pocket maximum