Health Insurance Meeting PPO’s, HDHP’s & HSA’s Center Grove Community School Corporation October 30, 2014
Introductions • Paul Gabriel, Center Grove CFO • Glennda Watson, Center Grove Benefits Specialist • Trevor Stevens, Consultant R. E. Sutton & Associates • Diane Tichenell, Account Manager Anthem Blue Cross and Blue Shield • Ruste Pontenburger, HSA Sales Manager The HSA Authority 2
Annual Enrollment • Annual Enrollment is an opportunity to complete the following: • Get information and enroll in the Delta Dental program • Get information and enroll in the VSP Vision program • Get information and enroll in the Anthem program. • Change, drop or add dependents to your Health, Dental, or Vision • Enroll in or make changes to your Flexible Spending Account- DECEMBER-AFA REPS WILL BE IN EACH BUILDING • Enroll in the Group Term Life and/or Long Term Disability programs – SUBJECT TO EVIDENCE OF INSURABILITY • Review and update your beneficiary designations on group life 3
Annual Enrollment (Cont.) • If you do not make any enrollment changes during Annual Enrollment: – Participation in Medical, Dental and Vision will remain the same – You will not be enrolled in a Flexible Spending Account for 2015 – You must enroll each year to make pre-tax contributions for health and/or dependent care expenses 4
How to Enroll • Visit the Center Grove web site ( www.centergrove.k12.in.us/forms ) and select “Insurance & Information.” • Click on the “Annual Enrollment Change” form. • After completing the form, submit it via email by clicking “Submit Form” or save the form and send it via email or interoffice mail to Glennda Watson (watsong@centergrove.k12.in.us). 5
Remember • All Annual Enrollment changes are effective January 1, 2015. • IRS regulations require that Annual Enrollment benefit elections remain in place for the entire plan year unless you experience an IRS-defined change in status. – A change in status, such as marriage, divorce, or the birth of a child, allows you to make a corresponding change to your elections within 30 days of the event. Deadline to complete enrollment changes: N OVEMBER 30, 2014 All Annual Enrollment Changes are Effective January 1, 2015 6
Let’s Define Some Terms • PPO Health Plan – This is the traditional health plan we have had for over 20 years. “PPO” stands for Preferred Provider Network • High Deductible Health Plan (HDHP) – Our new health plan with a $3,000-single and $6,000-family deductible • Health Savings Account (HSA) – A bank account you can use to pay health expenses 7
Should you choose the PPO Plan or the HDHP Plan? Q1: What are you paying now? Q2: What will your health care costs be in 2015? Q3: What would your total costs be (premium and out of pocket) under each plan? • Every employee’s situation is different, so you will have to decide for you and your family • Toward the end of this meeting, we are going to run through a few examples 8
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Center Grove Schools January 1, 2015 Anthem’s Mission Together, we are transforming health care with trusted and caring solutions.
Agenda ID Cards National Network – Blue Access Deductible / Out of Pocket (OOP) Plan Options Overview Preventive Care On-Line Services and Tools Q&A
ID cards, EOBs and Certificates • Goal is to have new ID cards in hand prior to January 1, 2015 for new members and members making a plan change only.. • 2 ID cards per family – can order more if needed • Tri-fold with ID cards to order Certificate Booklet. May also obtain on-line at www.Anthem.com • EOBs are not sent to members with zero $ responsibility
National Provider Network • Your coverage travels with you – in Indiana or outside of Indiana or outside of country • YRP – signifies Indiana based member – each state has their own BCBS • Blue Access is Indiana’s PPO network – up to 97 % of provider’s in state participate in the Blue Access network • How to find a doctor: – Ask your doctor – On-line at www.Anthem.com – Call Member Services
Your 2015 Health Care Plan Options • PPO Blue Access offerings: – Standard PPO - – HDHP / HSA option • High Deductible Health Plan - Blue Access for Health Savings Account (PPO) combined with • The tax advantages of a Health Savings Account (HSA)
Product Overview – Plan Options • All plans medically speaking cover or don’t cover the same things. • Only other differences between plans are dollar amounts – deductibles, out of pockets, co-insurances, co-pays and premiums • If in doubt of procedure coverage, submit Pre- Determination for guarantee of benefits. Contact Customer Service
Deductible / Out of Pocket (OOP) • Deductible Rule of Thumb – Percentage benefits such as office visits, in-patient/out-patient services apply to deductible first, then payable at percentage up to OOP. • All Deductibles and copays apply to OOP • Once OOP is met all covered in-network medical services paid at 100%. • HDHP/HSA Prescription coinsurance do apply medical deductible and OOP. Once deductible is met, OOP is met, covered prescriptions pay at 100%.
Preventive Care 100% Coverage Keep healthy people healthy NO Dollar $ Identify problems early Maximum on Preventive Care Services
Product Overview – Plan Options Center Grove Community School Corporation Summary of Benefits PPO HDHP Network Non-Network Network Non-Network $500/$1000 $750/$1500 $3,000/$6,000 $6,000/$12,000 Deductible (Single/Family) 20% 40% 0% 40% Coinsurance $1000/$2000 $2600/$5000 $3,000/$6,000 $12,000/$24,000 Out-of-Pocket Limit (Single/Family) Unlimited Unlimited Unlimited Unlimited Lifetime Maximum $30/$40 Deduct./Coins. Deduct./Coins. Deduct./Coins. Physician Office Visits (PCP/SCP) No Copay/Coins Deduct./Coins. No Copay/Coins Deduct./Coins. Preventive Care $200 Deduct./Coins. Deduct./Coins. Emergency Room $50 Deduct./Coins. Deduct./Coins. Urgent Care Deduct./Coins. Deduct./Coins. Deduct./Coins. Deduct./Coins. Behavioral Health (MH SUD) Prescription Drugs separate Out of Pocket Prescription Drugs - Pharmacy maximum - $4,000 single / $8,000 family $15 Generic $25 50% 0% 50% Brand $50 Non-formulary Mail Order $30 Generic $50 Not Covered $0 Not Covered Brand $100 Non-formulary Deductibles Apply to covered services listed with a percentage (%) coinsurance.
Anthem 360º Health Management MyHealth Advantage Proactive identification provides targeted and individualized messaging to members and providers about potential opportunities to: • Improve health • Avoid critical ongoing safety issues • Improved compliance with evidence based guidelines • Rapid response to urgent issues • Customized health information from the Harvard Medical School • Telephonic support from trained nurses
Anthem.Com Getting Started Log on to www.anthem.com to access a wide array of tools and resources to help manage your health and benefits – Go to www.Anthem.com – Upper right go to Members Log in and click Register Now – Complete simple form with your ID card information – Receive user ID and password via e-mail within minutes. Confidential access to tools, resources and information about the health benefits and services available to you.
MyAnthem Discounts SpecialOffers Online discounted offers available to Anthem members only for health related products and services, such as: – Jenny Craig – Fitness Clubs – Get Fit – Cosmetic Dentistry – TruVision – LensCrafters – Butt Out (Smoking Cessation Program) – Eat Right – Hearing – Complementary Medicine Shop online for discounted health related products and services
Q &A • Questions about your Anthem Health Plan: 1-800-295-4119 • Questions about your Health Savings Account: Your Financial Institution • Questions about tax rules and qualified medical expenses: IRS website at www.IRS.gov THANK YOU!
Getting The Most From Your HSA For the employees of: Center Grove Community School Corporation
The HSA Concept HSA-Qualified Health Plan Health Insurance ( High Deductible Health Plan ) Major Medical Policy Pays the medical bills once the deductible has been met Bank Account HEALTH SAVINGS ACCOUNT You and Your Tax advantaged checking account to pay Employer Fund current medical expenses or to save for future ones
HSAs and Health Insurance • HSAs are separate from your health insurance • Expenses processed through your health insurance provider will track towards your deductible and will be eligible to be paid from your HSA. o Doctor and hospital visits o Prescriptions • Expenses that are not processed through your health insurance provider do not track towards your deductible but are still eligible to be paid from your HSA. o Dental o Vision
Advantages of an HSA • Individual account – you own and manage it • Funds accumulate year-to-year – no “use it or lose it” provision • HSAs are portable – you keep your account and 100% of the funds when you change jobs or retire • Tax savings • Contributions are pre-tax or tax deductible • Earnings are non-taxable • Qualified distributions are tax-free
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