2013 - 2014eha early retiree plan benefit options
DESCRIPTION
2013 - 2014EHA Early Retiree Plan Benefit Options. INTRODUCTIONS Greg Long – EHA Field Representative Kent Trelford-Thompson – BCBSNE Account Executive Bobbi Hannigan – Union Bank. AGENDA Plan & Rate Renewal Benefit Changes $750 PPO Plan $1,650 PPO Plan - PowerPoint PPT PresentationTRANSCRIPT
2013 - 2014EHAEarly Retiree Plan Benefit Options
INTRODUCTIONS
Greg Long – EHA Field Representative Kent Trelford-Thompson – BCBSNE
Account Executive Bobbi Hannigan – Union Bank
AGENDA •Plan & Rate Renewal•Benefit Changes•$750 PPO Plan•$1,650 PPO Plan•$3,100 High Deductible Health Plan•Health Savings Accounts•How to Enroll
2013-2014 EHA Rate Renewal
• The Medical rates for all Early Retiree categories will increase by 9.44%.
• The Dental rates for all participants will increase by 5.94%.
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2013/14 Plan Rates/Early Retirees
EHA Early Retiree Renewal Rates
Health Coverage - Retirees Employee
Employee &
Child(ren)
Employee &
Spouse
EE, Spouse &
Child(ren)
$750 Deductible - Retirees $566.28 $1,003.86
$1,189.19 $1,503.22
$1,650 Deductible $477.79 $846.98$1,003.3
5 $1,268.30
$3,100 Deductible HSA-Eligible $477.79 $846.98 $1,003.35 $1,268.30
Early Retiree Rate Comparison
Plan Information
Employee EE& Children
EE & Spouse
EE & Family
$750 Plan
$566.28 $1,003.86 $1,189.19 $1,503.22
$1,650 PPO & $3,100 HDHP
Benefit Options(Rates Same)
$477.79 $846.98 $1,003.35 $1,268.30
Difference in Cost Monthly
Annually
$88.49
($1,061.88)
$156.88
($1,882.56)
$185.84
($2,230.08)
$235.02
($2,820.24)
2013-2014 Benefit Changes
Deductibles The $600 Deductible Plan will become a $750
Deductible Plan. The Dual Option $1,500 Deductible Plan will
become a $1,650 Deductible Plan. The Dual Option $2,850 Deductible Plan will
become a $3,100 Deductible Plan. Out‐of‐Network deductibles will be adjusted to
retain the current relationships to in-network amounts.
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2013-14 Benefit Changes
Coinsurance Out‐of‐Pocket Maximums The maximum on the $750 Deductible Plan will
increase to $2,250 employee and $4,500 family. The maximum on the Dual Option $1,650 Deductible
Plan will increase to $3,250 employee and $6,500 family.
There is no in‐network coinsurance on the Dual Option $3,100 Deductible Plan.
Out‐of‐Network coinsurance maximums will be adjusted to retain the current
relationships
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2013-14 Benefit Changes
Copaysa. The current $35 primary physician copay will decrease to $30.
b. The current $35 specialty physician copay will increase to $50.
c. The current $35 urgent care physician copay will increase to $50.
d. There will be a new $75 copay on emergency room visits.
e. On the Dual Option $1,650 Plan, the current $50 physician copay will be changed to copays of $45, $65, $65 and $90 for primary physician, specialty physician, urgent care and emergency room, respectively.
f. There will continue to be no copays on the $3,100 HSA eligible Plan.
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$750 PPO Plan Option
Deductible:
$750 Employee Only or $1,500 Family
Coinsurance 80% / 20%:
$2,250 Employee Only or $4,500 Family
Office Visit Copay:
$30, $50, $50, $75
Routine Care Benefit:Expanded Benefits due to PPACA.
Pharmacy Benefit:Generic 25% Coinsurance ($5 Min $25 Max)Formulary Brand 25% Coinsurance ($30 Min $60 Max)
Non-Formulary Brand 50% Coinsurance (60 Min $90 Max)
$1650 PPO Plan OptionDeductible:
$1,650 Employee Only or $3,300Family
Coinsurance 70% / 30%:
$3,250 Employee Only or $6,500 Family
Office Visit Copay:
$45, $60, $60, $90
Routine Care Benefit:Expanded Benefits due to PPACA.
Pharmacy Benefit:Generic 30% Coinsurance ($7 Min $30 Max)Formulary Brand 30% Coinsurance ($35 Min $70 Max)
Non-Formulary Brand 50% Coinsurance (60 Min $90 Max)
High Deductible Health Plans
What they are:• PPO and Rx plan that meets specific Federal
requirements• Consumer Driven Health Insurance• Advantages 1. Lower Premiums 2. Coverage for serious illness or injury 3. Earnings and Investments 4. 100% coverage 5. Put up to 100% of your deductible in an HSA.
$3,100 HDHP/HSA
Deductible:
$3,100 Employee Only or $6,200 Family
Coinsurance 100% / 0%
$0 employee only or $0 Family .
Office Visit Copay:
Applies to Deductible
Routine Care Benefit:Expanded Benefits due to PPACA.
Pharmacy Benefit:Applies to deductible.
NOTE:Any coverage other than Employee Only the entire family deductible must be reached prior to benefits being paid at 100%.
Maximum Plan Out of Pocket
• $750 PPO option: $3,000 Single/$6,000 Family
• $1,650 PPO option: $4,900 Single/$9,800 Family
• $3,100 HDHP: $3,100 Single/$6,200 Family
*All PPO plans have an additional Rx maximum copay of $2,500 Single/$5,000 Family ($3,100 HDHP Rx max is included in the deductible)
Plan Benefit Comparison
$750 Deductible $1,650 Deductible $3,100 HDHP/H S A
Deductible $750 $1,650 $3,100
Coinsurance $2,250 $3,250 $0
Office Visit (2 @ PCP) $60 $90 Deductible
Prescription Drug
Brand Name (times 12) ($45 per month) $540 $540 Deductible
Out of Pocket $3,600 $5,530 $3,100
Example of Out-of-Pocket Cost
Hypothetical Out-of-Pocket Expense
$750PPO
$1,650PPO
$3,100HSA
Allowable ChargeIs
$250
Members Cost Share $250
Members Cost Share $250
Members Cost Share$250
Allowable Charge Is
$750
Deductible = $750 Members Cost Share $750
Members CostShare $750
Allowable ChargeIs
$2,000
Deductible = $75020% of $1,250 = $250
$1000
Deductible = $1,65030% of $350 = $1050
$1,755
Members Cost Share$2,000
Allowable ChargeIs
$35,000
Deductible = $750Coins = $2,250
$3,000
Deductible = $1,650Coins = $3,250
$4,900
Deductible = $3,100
Health Savings Accounts
Bobbi Hannigan,
Health Savings Account Coordinator
Union Bank & Trust
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How to Enroll
• By Mid-July, eligible participants will receive information from BCBSNE: Call 402-458-4800 or 1-800-562-6394.
• Submit the Application by August 5 to ensure coverage for September 1.
• If changing to the HDHP/$1,500 PPO on January 1st, must have the application completed by December 2, 2013.
Key Points to keep in Mind
• Once you move to a higher deductible, you cannot move back to a lower deductible option
• Enrollment for the HDHP can be either September 1 or January 1.
• Annual Membership Dues are for September 1- August 31. No additional dues are charged for changes
• Members receive tax reduction of between 15%-35% depending on their status
Key Points to Remember
• If you move to one of the higher deductible plans, you must stay on that option for 3 years or until you reach the age of 65.
• HSA Accounts provide Triple Tax Savings
• Application Deadlines:
For September 1, August 5, 2013
For January 1, December 2, 2013
• EHA Customer Service- 1-877-721-2583
• Other questions you can call:20
Contact Information Greg Long – EHA Field Representative
(402) 440-1358
(Kent Trelford-Thompson
Account Executive BCBSNE
(402) 458-4810
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Questions?Thank you!