Our Mission Chartered by General Convention in 1978 Reports to - PDF document

Agenda  Introduction  The Episcopal Church Medical Trust • Medical Plans Episcopal Church Medical Trust • All Things High Deductible • Additional Benefits Healthcare Benefits for • Dental Plans The Diocese of Kansas Open Enrollment 2012  Wellness and Personal Responsibility Toni Marie Sutliff Regional Relationship Specialist Provinces VI/VII November 2011  Resources  Questions? 1 2 The Episcopal Church Medical Trust The Episcopal Church Medical Trust Our Mission …  Chartered by General Convention in 1978  Reports to Church Pension Fund Trustees “Balancing compassionate  Voluntary Employees’ Beneficiary Association (VEBA) Christian benefits  ERISA-exempt, free of most state benefit mandates with financial  Tax-favored not-for-profit church plan stewardship” 3 4 1

Who Can Participate? The Episcopal Church Medical Trust – Serving You  We are here to support you with: • Problem Resolution  Salaried (exempt) clergy and lay employees • Education and Awareness • Patient Advocacy  Hourly employees working a minimum of 20 hours/week (1,000 hours/year) Our Client Engagement Team is Available  Dependent children to age 30 Monday through Friday 8:30 am to 8:00 pm ET  Employees on short-term or long-term disability 7:30 am to 7:00 pm CT 1-800-480-9967 / mtcustserv@cpg.org 5 6 Your 2012 Medical Plan Choices Network Only Plan  Empire BCBS EPO 90 Episcopal Church Medical Trust Network and Non-Network Plans  Empire BCBS PPO 80/60  Empire BCBS HDHP/HSA Medical Plans– 2011 7 8 2

ALL PLANS– Preventive Care Routine and Preventive Services  $0 Copay Network Empire BlueCross BlueShield  Benefits include covered services received in a EPO 90 Plan physician’s office such as: (Exclusive Provider Organization) • Routine exams • Well-Woman and Well-Man exams • Routine exam X-rays and lab services www.empireblue.com (800) 352-3152 • Well-Child checkups • Immunizations • Other Routine Services 9 Empire BCBS EPO 90 – At a Glance Plan Provision Network Annual deductible (single / family) $200 / $500 Annual OOP max (single / family) $1,500 / $3,000 Empire BlueCross BlueShield Office visit copay $0 Preventive PPO 80/60 Plan $25 (PCP or specialist) (Preferred Provider Organization) Urgent care coinsurance 10% Member coinsurance 10% www.empireblue.com (800) 352-3152 Inpatient hospital coinsurance 10% Outpatient hospital copay 10% Emergency room care $100 (waived if admitted) 11 3

Empire BCBS PPO 80/60 – At a Glance Plan Provision Network Out-of-Network Annual deductible $500 / $1,000 $1,000 / $2,000 Empire BlueCross BlueShield (single / family) High Deductible Health Plan Annual OOP max $2,000 / $4,000 $5,500 / $11,000 Episcopal Church Medical Trust and (single / family) Health Savings Account Office visit copay $0 Preventive 40% (HDHP/HSA) $25 (PCP or specialist) Urgent care coinsurance 20% 40% Member coinsurance 20% 40% www.empireblue.com (800) 352-3152 Inpatient hospital $100 copay per day, 40% copay / coinsurance max $600 per admission; then 20% Outpatient hospital 20% 40% coinsurance Emergency room care $100 (waived if admitted) $100 (waived if 13 admitted) Empire BCBS HDHP – At a Glance HDHP/HSA – How the Pieces Work Together Plan Provision Network Out-of-Network (Medical & Rx Combined) High Deductible PPO Health Plan Annual deductible $2,700 / $5,450 $3,000 / $6,000 (single / family) with preventive services covered at 100% Annual Coinsurance max $1,500 / $3,000 $4,000 / $7,000 (excluding deductible) + Annual OOP max $4,200 / $8,450 $7,000 / $13,000 Health Savings Account (single / family) Office visit $0 Preventive 45% that allows employer and/or employees to make tax-free copay/coinsurance 20% contributions to save for future healthcare expenses Urgent care coinsurance 20% 45% + Member coinsurance 20% 45% Health and Decision Tools Inpatient hospital 20% 45% coinsurance to help employees become more knowledgeable consumers Outpatient hospital 20% 45% coinsurance Emergency room care 20% 20% 15 16 4

What Will it Cost the Employer in 2012? Health Savings Account - HSA  HSA is a tax-advantaged account Total Rate  Employee sets up the account and owns it Single Family HSA Annual Plus One Diff Plan Rate Rate Contrib  Balances accumulate and roll over year after year Rate Mo/Yr S/+One/ 2011/2 Mo/Yr Mo/Yr ution 012 Family  Account must be held by a qualified trustee • Empire BCBS / Mellon Bank $10,500/  IRS sets annual limits on contributions BCBS $875/ $1,574/ $2,447/ $0 $18,888/ 2.09% EPO 90 $10,500 $18,888 $29,364 • $3,100 single / $6,250 family $29,364  Anyone can make a contribution  Distributions for qualified healthcare expenses (as defined by $10,116/ BCBS $843/ $1,516/ $2,356/ $0 $18,192/ NA the IRS) PPO 80/60 $10,116 $18,192 $28,272 $28,272 $9,832/ BCBS $611/ $1,099/ $1,708/ $2,500/ $18,138/ NA HDHP/HSA $7,332 $13,188 $20,496 $4,950 $25,446 17 18 Health Savings Accounts - Contributions Creating the HSA  Employers and employees (or others) may contribute to  You must activate the account an employee’s HSA on an annual basis • Sign and return the card – designate beneficiaries and  Limits on annual contributions for 2012: receive personalized check book • Individual Coverage $3,100 • Activate online – after 1/1, and receive debit card only • Family Coverage $6,250 • The Medical Trust pays set up and maintenance fees • Employee is responsible for ensuring the maximum is not exceeded.  Cannot fund the account until it is set up!!  Additional contributions for those (account holder only) who will attain age 55 (or older) by the end of the year ($1000 for 2012).  Deadline for HSA contributions is April 15 th of the following year 5

Health Savings Accounts - Contributions Health Savings Accounts – Distributions  Employee contributions can be made on a pretax  Distributions from an HSA for qualifying medical basis expenses are tax-free • Through salary reduction by election prior to the beginning of the year, with a written cafeteria plan  Qualifying medical expenses are unreimbursed document, and/or costs incurred by the employee or dependent for • As an adjustment to income on the employee’s annual tax return medical care, including:  Employer contributions are not taxable income to the • HDHP deductibles and coinsurance employee • Post-employment healthcare costs (Medicare Part B premiums, etc.)  Employees that are enrolled in Medicare cannot have contributions to the HSA as of the date of • Long-term care premiums enrollment. Health Savings Accounts – Distributions Qualifying Medical Expenses  Other distributions from an HSA are subject to federal  Include (but not limited to): income tax and an additional 20% penalty (penalty is • Braces waived if the distribution is made after age 65 or on • Dental expenses account of death or disability) • Lasik surgery  Distributions do not have to be made in any year and can • Hearing aids  Do NOT include (and not limited to): be rolled over from year to year  Account earnings are not subject to taxation, if eventually • Health club memberships • Hair transplants used for qualifying medical expenses • Nutritional supplements  Distributions can be made for the qualifying medical • Teeth whitening expenses of dependents (but not domestic partners) • Over the counter medications  See IRS publications for assistance  Distributions can be made even after the employee is no longer eligible to contribute to an HSA 6

Using the HSA at the Office or Hospital How are distributions made?  Employee can use the HSA debit card at the provider’s office or pharmacy  Employee can write a check to the provider or pharmacy on the HSA account  Employee can pay provider or pharmacy out of the employee’s funds and reimburse him or herself from the HSA  Caution: • Employee must keep records to prove the distributions from the HSA were used for qualifying medical expenses • Employee is responsible for any overdraft fees on the HSA Using the HSA at the Pharmacy Health Savings Accounts – Death  If the employee’s spouse is the beneficiary of the HSA, the HSA will be treated as an HSA of the spouse after the employee’s death • No taxable event for Federal income tax purposes.  If there is a non-spouse beneficiary, the account ceases to be an HSA and the value of the account is taxed to the beneficiary • If the employee’s estate is the beneficiary, the HSA balance is included in the employee’s final Federal income tax return. 7