1 eha early retiree options for health insurance for 2011-2012 how to make the best decision for...

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1 EHA Early Retiree Options for Health Insurance for 2011-2012 How to make the best decision for you!

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1

EHA Early Retiree Options for Health Insurance for 2011-2012

How to make the best decision for you!

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How did you learn about today’s session?

• Article in EHA newsletter• Contact from school district• Contact from local education association• Contact from OSERS by email• Contact from EHA or Blue Cross personnel• Other

WHICH CONTACT WOULD YOU PREFER?

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Review of options

• Current $600 deductible PPO Plan– To maintain, do nothing!

• New plans– $1,500 deductible PPO Plan

• To start, call Blue Cross for application

– $2,850 HDHP Plan• To start, call Blue Cross for application• Consider enrolling in Health Savings Account

(HSA)

4

How can you decide which EHA plan to choose?

• Consider what you paid for health care last year in:– Office visit co-pay– Deductible for medical care– Co-pay for medical care– Co-pay for prescriptions– Premium saving for making a change

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Example of Costs for 6 office visits, $600 in tests, and 2 drugs per month

$600 PPO $1,500 PPO $2,850 HDHP6 o.v. @$35

$210 6 o.v. @ $50

$300 6 o.v. @ $165

$990

Ded. for tests

$600 Ded. for tests

$600 Ded. for tests

$600

24 Rx @ $30

$720 24 Rx @ $35

$840 24 Rx @ $60 $1,440

Co-pay @ 80/20

$0 Co-pay @ 70/30

$0 Total charges of $3,030 exceed deductible of $2,850

Cost

Prem sav

Total

$1,530

$0

$1,530

Cost

Prem sav

Total

$1,740

$ -970

$ 770

Cost

Prem sav

Total

$2,850

$ -970

$1,880

No tax break No tax break

Tax break for $4,050

Net cost

$ -1,000

$ 880

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Comparison for single coverage

Feature $600 ded. $1,500 ded.

$2,850 ded. HDHP

Deductible $600 $1,500 $2,850

Max out of pocket w/ ded.

$2,600 $4,500 $2,850

Office visit $35 $50 Inc. in ded.

Coins. 80/20 70/30 Inc. in ded.

Drugs – % copay

$ minimums

25% / 50%

$5 / $30 / $60

30% / 50%

$7 / $35 / $60

Inc. in ded.

Routine care $500 subject to ded. and coins.

$500 subject to ded. and coins.

$500 not subject to ded.

Premium savings None $970 per year $970 per year PLUS tax break

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Example of out-of-pocket costHypothetical

out-of-pocket expense

$600

PPO

$1,500

PPO

$2,850

HDHP

$400 in covered charges

You pay entire amount

$400

You pay entire amount

$400

You pay entire amount

$400

$1,000 in covered charges

$600 applied to deductible; $400

paid 80/20%: You pay $680

You pay entire amount

$1,000

You pay entire amount

$1,000

$25,000 in covered charges

$600 applied to deductible; stop-loss at $2,000: member

pays $2,600

*Does not include Rx

$1,500 applied to deductible; stop-loss at $3,000: member pays

$4,500

*Does not include Rx

$2,850 applied to deductible; 100%

coverage after deductible:

member pays $2,850

*Does include Rx

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To make a change, do this:

• Call Blue Cross at 1-800-562-6394– Tell them you are with EHA– Ask for application to change policy– Have your Blue Cross ID number ready– Fill out application and return to Blue Cross

• If you want to open a Health Savings Account, contact Union Bank (or your financial provider) after you sign up for the HDHP– Go to EHA web site to sign up on-line

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www.ehaplan.org

Click here to sign up for a

Health Savings Account

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Click on logo to go to Union Bank web site

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Click here

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Click Accept

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Find Nebraska and click Next

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Click on “Deposit Health Savings Account” – Single Coverage (or

Family Coverage), then scroll down and click “Next.”

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Fill out on-line application for

account

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Enter: “Educators

Health Alliance” as your employer

to get no-fee account, and say you are “Retired”

for occupation

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Last steps for HSA account

• Either submit application on-line, or print forms and mail to Union Bank

• Wait for your ID card to be issued (it is a debit card that can be used for office visit costs, drug costs, etc.)

• FUND your account by making check payable to Union Bank and mailing in deposit

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If you change plans, you will need to stay in the plan you

choose for 3 years before you can switch back to the older

plan. You can change by August 1, or Dec. 1, or next

year….

Questions?