1 hebrew union college 2011 benefits presentation presented by: trista owens, usi midwest

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1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

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Page 1: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

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Hebrew Union College 2011 Benefits Presentation

Presented By:

Trista Owens, USI Midwest

Page 2: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

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Meeting Overview

Medical InsuranceHealth Care Reform changesBase PPO PlanBuy Up PPO PlanLumenos H.S.A. PlanGood News! No change to Employee Contributions

Dental Insurance-Plan DesignEmployee Contributions

Life/AD&D and Long Term Disability- No Changes

Flexible Spending Account

Open Enrollment Procedures and Deadlines

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Health Care Reform

Changes that will go into place at renewal-

No lifetime maximum (current $5,000,000) or unreasonable annual limits on essential benefits

Dependents are now eligible for health insurance up to age 26

Preventive care on all plans will be covered at 100% with no copay or deductible (H.S.A. plan currently already has this coverage)

Page 4: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

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Base PPO Plan

In Network- Anthem National Blue Card NetworkCalendar Year Benefits Deductible- Single $1,000; Family $2,000 Coinsurance- 80% Anthem; 20% MemberOut of Pocket Maximum- Single: $3,000; Family $6,000Office Visit Copay- $25 copayEmergency Room- $100 copayUrgent Care- $50 copayPrescription Drugs- $100 deductible per person per calendar year then $10 Tier 1; $30 Tier 2; $50 Tier 3Lifetime Maximum- Unlimited

This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.

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Buy Up PPO Plan

In Network- Anthem National Blue Card Network

Calendar Year Benefits

Deductible- None

Coinsurance- 90% Anthem; 10% Member

Out of Pocket Maximum- Single: $1,000; Family $2,000

Office Visit Copay- $20 copay

Emergency Room- $50 copay

Urgent Care- $35 copay

Prescription Drugs- $10 Tier 1; $25 Tier 2; $45 Tier 3

Lifetime Maximum- Unlimited

This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and eligibility.

Page 6: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

Lumenos H.S.A. Plan Overview

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Your Lumenos In Network H.S.A.Plan Details At-a-Glance

Lumenos Plan Single Coverage Family Coverage

Preventive Nationally recommended servicesNo cost, no deduction from HSA with in-

network providers

Traditional Health Coverage

Annual Calendar Year Deductible-

You will be given credit for any deductible met from 1/1/11 through

6/30/11 (if you are currently in the Base PPO plan)

$3,000$6,000 Non-Embedded

Medical Services

Prescription Copays after the deductible is met

100% for In-Network Services

Tier 1: $10; Tier 2: $30; Tier 3 $50; Tier 4: 25%

HSA

You can use the funds from your Health Savings

Account to help satisfy your annual

deducible

Employer’s 1st Year allocation (Half will be funded 7/1/11 and the other half

1/1/12)

Annual IRS HSA contribution maximum combined between the

employer and the employee

$1,000

$3,050

$2,000

$6,150

This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and

eligibility.

Page 8: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

How Does the Lumenos Plan Work?

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Lumenos Plan with an HSA

With the Lumenos plan, you have a high deductible medical plan coupled with a Health Savings Account (HSA)

• You can fund your HSA with pre-tax payroll contributions or post-tax contributions (which are deductible when you file your taxes)

• The money in your HSA can be used to pay for your medical care, including prescriptions that go towardsatisfying your deductible

• Once you’ve satisfied your deductible the plan’s Traditional Health Coverage prescription copays kicks in.

Page 10: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

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Using Your Lumenos Plan to Get CareWhen you visit an in-network doctor:

Show your ID card at the time of serviceTypically you pay nothing at the time of service.

Your provider will file a claimYou will receive a Claim Recap showing the total cost

and the “allowed” cost. Your provider will then bill you for the “allowed” cost of the service(s)

If you have funds in your HSA you can pay your provider using your HSA checkbook or debit card

When you visit a doctor that is not in the network:Show your ID card at the time of serviceYou may be asked to pay at the time of services.Use your HSA checkbook or debit card to pay your

provider for services (provided you have the funds available)

If your provider does not file a claim on your behalf, you will need to file a claim with Anthem BCBS to ensure expenses get applied towards your out-of-pocket. You can download a claim form at anthem.com

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Using Your HSA Plan to Get Care

When you visit a pharmacy:Show your ID card at the pharmacy

Until you have satisfied your annual deductible you will pay the full discounted cost of your prescription drug

You can pay for your prescription at the pharmacy using your HSA debit card or checkbook as long as there are funds available in your HSA account.

After the deductible is met you will pay the applicable copays of $10/$30/$50/25%.

Page 12: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

Using your HSA for Qualified Medical Expenses

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Can I Use My HSA to Pay for Non-Qualified Medical Expenses?

Yes, but…Any amount you spend will be considered taxable income (you

will have to pay taxes on the amount used), and you will have to pay a 20% penalty on the

Non-qualified expenses will not count toward your deductible

Once you are 65, you can withdraw the money without penalty, but it will be considered taxable income

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Can I Still Have an FSA?

You can, if your employer offers one of the following limited purpose FSAs:

A limited purpose FSA which limits reimbursements to eligible dental and vision care; or,

A limited purpose high deductible FSA (LPHD FSA) provides immediate reimbursement of your dental and vision expenses as well as reimbursement of your qualified medical expenses once your deductible requirement is met

Page 15: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

Funding Your HSA

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Making Contributions to Your HSA

There are several ways you can contribute to your account:Tax-free through payroll deductionsPost-tax by personal check

When you file your taxes, you can make an adjustment to your gross income to receive the tax benefit

You’ll receive deposit slips for your HSA in the mail

Anyone may contribute to your HSA, provided the total contributions to your HSA do not exceed your maximum allowable annual limit

$3,050 for individual coverage$6,150 for family coverage

You can make catch-up contributions if you are 55 years of age or older ($1,000 for 2011)

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HSA Tax Benefits

Contributions made via payroll deduction are pre-taxReduces your federal adjusted gross income

(the amount you pay tax on)

Contributions made by personal check are post-taxYou will need to make an adjustment on your gross income

when you file your taxes to receive the tax benefit

If you use your HSA for a non-qualified expense (e.g. not covered services or qualified medical expenses), you will have to pay tax on the expense and are subject to a 20% penalty on the amount.

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Am I Eligible for the HSA Plan?

The IRS and the U.S. Department of the Treasury have specific rules on who can open an HSA.

You can open an HSA if you: Are enrolled in the Lumenos HSA plan, because it includes

an HSA-compatible health plan

Are a U.S. resident and not a resident of Puerto Rico or American Samoa

Are not enrolled in Medicare or another non-qualified plan

Are not claimed as a dependent on another individual’s tax return

Are not active military

Others – refer to online health site

Note: You cannot open an HSA if you have coverage under any other health plan that is not an HSA-compatible health plan.

Page 19: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

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Who is Holding the Funds in My HSA?

A qualified financial institution will hold and invest the money. Hebrew Union has Partnered with 5/3.

Services provided: Your debit card and PIN

Your HSA checkbook

FDIC insurance

Monthly account statements

Year-end tax forms

*If your employer has selected a financial institution to administer your HSA that is not one of Anthem’s partner banks, or you choose to have your HSA at a different bank, you will not have access to HSA information through Anthem Customer Service or the online health site. Investment rules and fees for your account may also vary.

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Employee Monthly Contributions

Base Plan or HSA Plan

The current Salary Based Tier will continue:

Salary under $35,000 is charged 1.75 % for single and 3.25% for Family.

Salary $35,000 to $50,000.00 is charged 2.25% for single and 3.75% for family.

Salary over $50,000 – is charged 2.75% for Single and 4.25% for family.

Buy Up Plan

Buy Up Single = % of salary noted above plus an additional $131.04 per month

Buy Up Family = % of salary noted above plus an additional $393.14 per month

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Dental Insurance- Guardian

The Dental plan design with Guardian will remain the same.

In Network- Calendar Year Benefits

Deductible: Single $50; Family $150 (waived for Preventive)

Annual Maximum Per Person: $1,000

Preventive: Covered in Full

Basic Service: Covered at 80% after deductible

Major Service: Covered at 50% after deductible

Orthodontia: Covered at 50% to $1,000 lifetime maximum per dependent child up to age 19

To look up a provider please log on to www.guardian.com.

Customer Service-1-800-541-7846

2011-2012 Monthly Employee Contributions

Single: $8.31

Family: $35.79

Page 22: 1 Hebrew Union College 2011 Benefits Presentation Presented By: Trista Owens, USI Midwest

Flexible Spending Account

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What is a Flexible Spending Account or FSA?

Pay expenses with tax-free money

Three Accounts- Health Care, Limited Purpose (for HSA participants) & Dependent Care

Voluntary election of payroll deductions

Money held in your name

Submit claim for reimbursement

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Think of what you buy with your money. . .

Deductibles

Rx Drugs

Copayments

Day Care

Eyeglasses/Contacts

Lasik Surgery

Dental Work

OTC Provision

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Flexible Spending Account Health Care ReimbursementEligible Expenses- see FSA packet$7,000 Maximum limitUse worksheet to estimate total expensesCalculate total contribution

Dependent Care ReimbursementEligible Expenses- see FSA packetIf married, spouse must work or attend school full-timeMaximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return

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Flexible Spending Account Limited Purpose Account

Limited Purpose Flexible Spending Account is a tax savings account that reimburses employees for eligible dental and vision care expenses in conjunction with a HSA.

Eligible Expenses- dental and vision only$7,000 Maximum limitUse worksheet to estimate total expensesCalculate total contribution

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Open Enrollment Summary

Health Insurance- If you do not want to switch plans your plan will automatically renew.

HSA Bank Account- More information will be emailed out to the campus on how to enroll and set up your H.S.A. bank account if you enroll in the H.S.A plan.

FSA- Please complete the enrollment form and turn it into the Cincinnati Benefits department

If you would like to make any changes to your Dental, Life or Supplemental Life please contact HR for a change form. As a reminder there is not an open enrollment for Dental. If you would like to increase your supplemental life insurance evidence of insurability is required. You will be approved or declined based on your current health status.

ALL FORMS ARE DUE TO HR NO LATER THAN JUNE 20th

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Questions?