Open Enrollment November 1 -15, 2018 • Active Open Enrollment • Health Plan Financial Status • Dental & Vision Premiums • High Deductible Health Plan (HDHP) • Health Savings Account • PPO Plan Design Changes • Flexible Spending Accounts • Premium Assistance • PPO Premiums • Health Plan Comparisons (PPO vs. HDHP) 2 Disclaimer: This presentation is intended to serve as a high-level benefits overview. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages or tax-favored accounts. Employees are strongly encouraged to visit hr.ua.edu/benefits/openenrollment for additional information and more comprehensive resources.
Active Open Enrollment • All benefit-eligible employees who currently have health, dental, vision insurance or flexible spending accounts must ACTIVELY participate in Open Enrollment. • Why? Addition of the new high-deductible plan choice. ACA requires offer of coverage to 95% of eligible employees. • What can you do during Open Enrollment? ✓ Add or change existing insurance coverage. ✓ Enroll in healthcare FSA, dependent care FSA, or HSA. ✓ Add or remove dependents. You must take action to enroll or re-enroll in health, dental, vision insurance or flexible spending accounts, or you and your dependents will have NO COVERAGE in 2019! 3
Health Plan Financial Status Projected Projected Calendar Year 2014 2015 2016* 2017* 2018** 2019 Total Revenues $48,142,627 $49,398,936 $50,486,393 $37,144,541 $38,150,762 $42,935,247 $49,686,696 $50,457,312 $57,383,173 Total Paid Health Costs $35,516,273 $40,254,825 $45,993,080 Difference $1,628,268 -$2,104,063 -$3,057,833 -$1,544,069 -$1,058,376 -$6,896,779 * UA contributed an extra $2 Million in 2016 and an extra $1.2 Million in 2017 to help keep the BC Reserve Fund solvent. ** 17% avg. premium increase for EE’s was implemented for 2018, after a 10% rate increase in 2017. Bottom Line – Based on our actual losses from 2015-2017 and our projected losses for 2018-2019, UA has an overall ($14,661,120) loss. 4
Cost Drivers UA’s self -funded health plan has an overall ($14,661,120) loss since 2015. • Catastrophic Claimants • At least one $1,000,000 member each year. • 30+ individuals with over $100,000+ claims each year. • Specialty Prescription Drugs • Harvoni - $90,000 per 12-weeks • Humira - $4,800 - $6,400 per month • Gilenya - $7,700 per month • No premium increases from 2012, 2013, 2015, and 2016. • Overall Inflation - 8% medical, 10% Rx 5
Dental Premiums Tier 2018 2019 Employee $28.09 $28.09 Employee + 1 $55.04 $55.04 Family $79.75 $79.75 Vision Premiums Tier 2018 2019 Employee $5.74 $5.74 Employee + 1 $10.59 $10.59 Family $18.52 $18.52 Disclaimer: This presentation is intended to serve as a high-level benefits overview. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages or 6 tax-favored accounts. Employees are strongly encouraged to visit hr.ua.edu/benefits/openenrollment for additional information and more comprehensive resources.
We used to have passive enrollment. You could keep your current benefits without logging in to BenefitFocus. THIS S YEA EAR IS S DIFF FFER ERENT! ENT! You must ACTIV IVEL ELY participate in Open Enrollment. Select your health, dental, vision coverage & flexible spending accounts, or NO COVER ERAGE GE in 2019! 9! 7
What is a High Deductible Health Plan (HDHP)? HDHP PPO Health Plan High Deductible Health Plan Preferred Provider Organization Premiums Lower Higher Deductibles Higher Lower Member Cost Share Coinsurance (20%) Copayments (after deductible is met) Health Savings Account (HSA) Healthcare FSA Tax-Favored Accounts Dependent Care FSA Dependent Care FSA Date of Hire or Coverage Effective First of the month following date of hire First of the month following Third Party Administrator Both plans are administered by Blue Cross & Blue Shield of Alabama. Network Access Both plans have the same network access and provider discounts. Covered Services Both plans have the same covered services. Preventive Services Both plans cover FREE preventive services at no cost share to the member. Disclaimer: This presentation is intended to serve as a high-level benefits overview. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages or tax-favored 8 accounts. Employees are strongly encouraged to visit hr.ua.edu/benefits/openenrollment for additional information and more comprehensive resources.
By the Numbers – HDHP vs. PPO Premium HDHP PPO Employee $54 $108 Family without a Spouse* $193 $386 Family with a Spouse* $224 $447 First-Dollar Deductible HDHP** PPO Employee $1,400 $350 ($175 Medical + $175 Rx) Family without a Spouse* $2,800 per family $350 per person Family with a Spouse* $2,800 per family $350 per person Out-of-Pocket Maximum HDHP** PPO Employee $3,000 $5,000 ($2,500 Med + $2,500 Rx) Family without a Spouse* $6,000 $10,000 ($5,000 Med + $5,000 Rx) Family with a Spouse* $6,000 $14,300 ($7,150 Med + $7,150 Rx) * The IRS treats any non-single contract as a family contract for deductibles and out-of-pocket maximums. ** Medical and Rx deductibles and out-of-pocket maximums are combined for the HDHP. 9
Health Savings Account (HSA) vs. Healthcare FSA HSA is designed to be a “ consumerism tool .” It is a savings account owned by YOU , the employee. It is your money to manage! HSA Healthcare FSA Required Insurance High Deductible Health Plan Traditional PPO Account Type Savings Spending Ownership You! The Employee The University of Alabama $3,500 Employee Contribution Limits $2,650 $7,000 Family Funds Available Funded per paycheck Beginning of the year “Use it or lose it” Rule Indefinite Carryover Expenses must be incurred within the plan End of Year Balance Expenses must be incurred after HSA is open, year and reimbursed by March 31 of the but money can be disbursed in later years. following year. Portability Yes No Disclaimer: This presentation is intended to serve as a high-level benefits overview. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages or tax-favored 10 accounts. Employees are strongly encouraged to visit hr.ua.edu/benefits/openenrollment for additional information and more comprehensive resources.
Health Savings Account Benefits • Tax- favored savings account for “ qualified medical expenses .” ( IRS Pub. 502) • Account is administered by Total Administrative Services Corp. ( TASC ). • Triple Tax Savings 1. Tax free payroll contributions from employee and The University. 2. Tax free earnings accumulate, if invested. 3. Tax free distributions, if used for qualified medical expenses. • Retirement Savings Tool • IRA-like investments including annuities, CDs, stocks, mutual funds, etc. • Age 55+ can contribute an additional $1,000 to HSA each year. • After age 65, can no longer contribute to HSA if enrolled in Medicare but can use HSA funds to pay for Medicare premiums or long-term care. Disclaimer: This presentation is intended to serve as a high-level benefits overview. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages or tax-favored 11 accounts. Employees are strongly encouraged to visit hr.ua.edu/benefits/openenrollment for additional information and more comprehensive resources.
HSA Contributions Employee HSA contributions are tax-free via payroll deductions. Unlike the FSA, you can change this monthly deduction throughout the year and contribute up to the following annual limits: Account Employee Only Family* Annual Contribution Limit $3,500 $7,000 * The IRS treats any non-single contract as a family contract for deductibles, out-of-pocket maximums, and contributions. In 2019, The University of Alabama will also contribute to your HSA. You must enroll and open your HSA account to receive this money! It is not automatic. UA “Seed Money” Contribution Tier Employee Only $400 per year Family without a Spouse $800 per year Family with a Spouse $800 per year 12
IRS Eligibility Rules for HSA In order to contribute to a Health Savings Account … • You must be covered by UA’s qualifying HDHP. • You cannot also be covered by a non-HDHP plan. ✓ Example : You cannot have other coverage on a spouse’s PPO plan. ✓ Example : You cannot be enrolled in Medicare. • You cannot be listed as a dependent on another person’s tax return. • You cannot use your HSA to pay for ineligible dependents. ✓ IRS considers child dependents up to age 24 if full-time student. ✓ ACA allows children to remain on a parent’s plan until age 26 . • You or your spouse cannot be enrolled in a healthcare FSA. Disclaimer: This presentation is intended to serve as a high-level benefits overview. It is not an exhaustive list of all requirements, limitations or exceptions related to insurance coverages or tax-favored 13 accounts. Employees are strongly encouraged to visit hr.ua.edu/benefits/openenrollment for additional information and more comprehensive resources.
It’s all about TH THE E PR PROC OCES ESS . Follow the Benefits process by AC ACTIVE IVELY LY participating in Open Enrollment. Nov ovember ember 1 - 15 15 If you do not enroll or re-enroll in benefits, then you will have NO COVERAGE in 2019! 14
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