2013 - 2014eha early retiree plan benefit options

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2013 - 2014EHA Early Retiree Plan Benefit Options

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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 Presentation

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Page 1: 2013 - 2014EHA Early Retiree Plan Benefit Options

2013 - 2014EHAEarly Retiree Plan Benefit Options

Page 2: 2013 - 2014EHA Early Retiree Plan Benefit Options

INTRODUCTIONS

Greg Long – EHA Field Representative Kent Trelford-Thompson – BCBSNE

Account Executive Bobbi Hannigan – Union Bank

Page 3: 2013 - 2014EHA Early Retiree Plan Benefit Options

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

Page 4: 2013 - 2014EHA Early Retiree Plan Benefit Options

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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Page 5: 2013 - 2014EHA Early Retiree Plan Benefit Options

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

Page 6: 2013 - 2014EHA Early Retiree Plan Benefit Options

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)

Page 7: 2013 - 2014EHA Early Retiree Plan Benefit Options

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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Page 8: 2013 - 2014EHA Early Retiree Plan Benefit Options

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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Page 9: 2013 - 2014EHA Early Retiree Plan Benefit Options

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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Page 10: 2013 - 2014EHA Early Retiree Plan Benefit Options

$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)

Page 11: 2013 - 2014EHA Early Retiree Plan Benefit Options

$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)

Page 12: 2013 - 2014EHA Early Retiree Plan Benefit Options

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.

Page 13: 2013 - 2014EHA Early Retiree Plan Benefit Options

$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%.

Page 14: 2013 - 2014EHA Early Retiree Plan Benefit Options

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)

Page 15: 2013 - 2014EHA Early Retiree Plan Benefit Options

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

Page 16: 2013 - 2014EHA Early Retiree Plan Benefit Options

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

Page 17: 2013 - 2014EHA Early Retiree Plan Benefit Options

Health Savings Accounts

Bobbi Hannigan,

Health Savings Account Coordinator

Union Bank & Trust

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Page 18: 2013 - 2014EHA Early Retiree Plan Benefit Options

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.

Page 19: 2013 - 2014EHA Early Retiree Plan Benefit Options

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

Page 20: 2013 - 2014EHA Early Retiree Plan Benefit Options

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

Page 21: 2013 - 2014EHA Early Retiree Plan Benefit Options

Contact Information Greg Long – EHA Field Representative

[email protected]

(402) 440-1358

(Kent Trelford-Thompson

Account Executive BCBSNE

[email protected]

(402) 458-4810

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Page 22: 2013 - 2014EHA Early Retiree Plan Benefit Options

Questions?Thank you!