OPEN ENROLLMENT Marianne Nicoletti, Oswald Companies January 7, - PowerPoint PPT Presentation

OHIO ASSOCIATED ENTERPRISES OPEN ENROLLMENT • Marianne Nicoletti, Oswald Companies January 7, 2016

AGENDA • 2016 Open Enrollment • What’s new for 2016 • Your Medical Plan • Your Dental Plan • Your Life Insurance Plan • Next Steps 2

2016 OPEN ENROLLMENT • Open Enrollment is January 8 th – January 18 th • All enrollments and changes must be made during Open Enrollment  Open enrollment is the one time during the year that you are able to make changes to your plans . If you previously waived coverage, you may now enroll in the plan & if you are currently covered & wish to add dependents, you may do so as well  The only other time during the year that you have the ability to make changes to the plan is if you experience a Qualifying Event, such as a loss of coverage, divorce or marriage. If you do experience a Qualifying Event, please contact HR within 30 days of the event to complete the necessary paperwork 3

WHAT’S NEW FOR 2016  Medical – slight change to prescription copays and minor increase in cost  Dental – no change in plan design with a minor increase in cost  Life Insurance – no change in plan design or cost 4

Healthcare Reform Beginning in 2014, all Americans are required to purchase health insurance, or pay a • penalty Individuals can either obtain coverage through their employer-sponsored health plan • or they can purchase coverage on their own 5 Open Enrollment in the Marketplace (Exchange) opens on November 1, 2015 •

6 FORM 1095-C

FORM 1095-C • In January you will receive two form 1095-C(s): • One from Ohio Associated Enterprises • One from Anthem • These forms will need to be filed with your 2015 tax return. • The tax ruling applies to all full-time, benefits eligible employees regardless of their enrollment status within the benefits plan. 7

8 FORM 1095-C

9 MEDICAL

WHAT’S NEW FOR 2016 - MEDICAL • Medical Plan changes include: • Prescription Drugs – Retail • Tier 4 – the monthly maximum is $250 (from $200) • Prescription Drugs – Mail Order • Tier 1 – increased to $20 (from $10) • Tier 2 – increased to $105 (from $88) • Tier 3 – increased to $210 (from $175) • Tier 4 – the monthly maximum is $250 (from $200) • These changes are based on the way Anthem filed their plans for 2016 • Premium Contributions – slight increase in employee cost 10

2016 MEDICAL PLAN BENEFITS H.S.A. Deductible (Single/Family) $2,600/$5,200 Coinsurance 0% after Deductible Out-of-Pocket Maximum $3,500/$7,000 (Single/Family) Office Visit 0% after Deductible (PCP/Specialist) Inpatient Hospital Services 0% after Deductible Outpatient Surgical 0% after Deductible Services Diagnostic Services 0% after Deductible Emergency Room 0% after Deductible Services Urgent Care 0% after Deductible Retail Rx (30-day) – $10/$35/$70/ 25% to $250 copays double after 3 rd fill max, after deductible at retail $20/$105/$210/ 25% to $250 max, after Mail Order Rx (90-day) deductible New in 2016: All covered expenses (including Deductible, Coinsurance & both Medical/Rx Copays) accumulate towards the Maximum Out-of-Pocket • This is an illustration of In-Network benefits, but please note that the plan does also provide 11 coverage outside of the network. Please refer to the plan documents for details & final confirmation of coverage

E LIGIBILITY FOR HSA’ HSA’ S LIGIBILITY FOR HSA Eligibility In order to be eligible to make pre-tax contributions to a Health Savings Account, individuals must:  Be covered under an HDHP on the first day of the month that the account is established and the first day of the month in which deposits are made.  Not also be covered under any other health plan that is not an HDHP. Certain types of limited benefit plans may be ok, such as a cancer policy, accident policy or a fixed daily benefit policy (hospital indemnity).  Not be entitled to benefits under Medicare.  Not be claimed as a dependent on another person’s tax return. 12

Q UALIFIED UALIFIED M EDICAL EDICAL E XPENSES XPENSES Eligible Expenses These Expenses are Eligible for Reimbursement from an HSA:  Diagnostic Testing  Alcoholism Treatment  Drug Addiction Therapy  Ambulance  Anesthetists  Eyeglasses  Arch Supports  Hospital Bills  Artificial Limbs  Hearing Aides  Blood Tests  Insulin Treatments  Braces  Lab Tests  Contact Lenses  Chiropractic Visits  Operating Room Costs  Crutches  Oral Surgery  Dental Treatments/X-Rays  Organ Transplant  Dentures  Orthopedic Shoes  Dermatologist Visits  Spinal Fluid Test  Oxygen & equipment  Splints  Physician Services  Sterilization  Physiotherapist Services  Therapy Equipment  Postnatal Treatments  Vaccines  Prenatal Care  Vasectomy  Prescription Drugs  Vitamins (if prescribed)  Psychiatrist Services  Wheelchairs  Psychologist Services  X ‐ Rays 113 This is just a partial list of the eligible HSA expenses. Please visit the IRS website & Publication 502 for a complete listing.

How the HSA Plan Works HSA Payment Process *Pr e se nt ID c ar d to *Doc tor se nds *Whe n you have *Doc tor bills you me dic al c laim to ne twor k doc tor . c laim ac tivity, you for payme nt. Anthe m. will r e c e ive an *Do NOT pay for 1. You c an use your E xplanation of *Anthe m applie s me dic al se r vic e s at HSA to pay. Be ne fits (E OB) fr om the time of se r vic e . ne twor k disc ount Anthe m showing 2. Or you c an and notifie s doc tor *You will pay for R x how the c laim was c hoose to pay of amount you at the phar mac y. pr oc e sse d & the anothe r way (c ash, may owe . amount that you c r e dit c ar d) and owe . r e imbur se your se lf fr om your HSA late r . 14 *Always make sur e the amount the pr ovide r says you owe matc he s the amount the E OB indic ate s owe d be for e se nding payme nt.

HSA RECORDKEEPING • K e e p yo ur re c e ipts a nd o the r fo rms (E OBs) • Yo u must ke e p re c o rds suffic ie nt to pro ve to I RS tha t: • Withdra wa ls fro m HSA we re fo r q ua lifie d me dic a l e xpe nse s; a nd • T he e xpe nse wa s no t pa id fo r o r re imb urse d b y a no the r so urc e o r ta ke n a s a n ite mize d de duc tio n • Yo u c a n withdra w mo ne y fro m yo ur HSA to re imb urse yo urse lf fo r e xpe nse s pa id in a prio r ye a r a s lo ng a s the y we re inc urre d o n o r a fte r the da te the HSA wa s e sta b lishe d 15 15

HSA RECORDKEEPING • T he b a nk re po rts a ll withdra wa ls a nnua lly o n F o rm 1099 SA • Yo u re po rt the a mo unt o f withdra wa ls use d fo r q ua lifie d me dic a l e xpe nse s o n yo ur ta x re turn • Yo u must file F o rm 8889 a s pa rt o f the ir a nnua l ta x re turn. 16

HSA CONTRIBUTION LIMITS 2015 2016 Self-only $3,350 $3,350 Coverage Family $6,650 $6,750 Coverage Catch-up $1,000 $1,000 Provision (for aged 55+) Meritec will contribute $250 for each individual who enrolls in the plan in the first year, then will provide a match up to $75 per pay. • Contributions can be made through pre-tax payroll deductions • Employees can make after tax deposits directly and claim the deduction when filing their tax return 17 • The totals include what the employer and employee contribute collectively

PREVENTIVE CARE • Preventive care is covered at 100% • Flu shots are covered under preventive (at 100%) • Regular preventive care helps reduce risk of disease No deductible. • Detect health problems early No copayment. No coinsurance. • Protect you from higher costs 100% coverage . down the road • May potentially save your life 18

Anthem Member Website  Anthem Care Comparison Tool  Health & Wellness Resources  Health & Wellness Discounts  Plan Information  Claims & EOB’s • MyHealth@Anthem • Future Moms • ConditionCare Programs • ComplexCare • 24/7 NurseLine 19

ACCOUNT SELF-SERVICE SOLUTIONS • Integrated dashboard displaying balance and recent claim activity • Online payments or reimbursement • Download forms • Manage investments • Obtain answers to FAQs • Education video library • Year-to-date information (for tax returns) • Order checks and debit cards Single sign-on link from Anthem.com 20

mobile provider mobile ID card directory 21

What is LiveHealth Easier and less Online? expensive than urgent care. LiveHealth Online is a convenient way for employees to interact with a doctor via live, two-way video on their computer or mobile device. 22 LiveHealth Online: • Is available anywhere you have an internet connection • Is available 24 hours a day/7 days a week • Provides access to in-network, U.S. board-certified doctors • Offers help at the same price as (or less than) a regular doctor visit • Doctors can ePrescribe to local pharmacies (where applicable) • Takes member payments via credit card • Register securely, and conveniently online LiveHealth Online is the trade name of Health Management Corporation, a separate company providing telehealth services on behalf of Anthem Blue Cross and Blue Shield. 22

LIVEHEALTH ONLINE SM  Online healthcare when you need it  Immediate, life consultants  Choice of physicians www.livehealthonline.com 23