saint louis university employee benefits 2015 annual enrollment
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Saint Louis UniversityEmployee Benefits 2015 Annual Enrollment
Benefits Overview—Coverages Offered
Medical/Prescription Drug
Vitality Wellness Program
Voluntary Dental
Health Savings Account
Flexible Spending Accounts
Basic Term Life and AD&D
Voluntary Term Life
Voluntary AD&D
Long Term Disability
Long Term Care
Business Travel Accident
New this year! (Non-Union Employees Only)
Voluntary Vision Voluntary Accident
Medical/Prescription Drug Benefits
Annual Enrollment 2015
Highlights Effective January 1, 2015
Medical - UnitedHealthcarePlus Plan: Medical and Prescription drug copays will accumulate
towards the out-of-pocket maximum in the Plus Plan QHDHP Plan
No plan changes Health Savings Account
The Vitality™ Wellness Program Participants save on medical premiums and earn rewards! Health screenings and HRA completion are needed to receive wellness
discount If covering your spouse, both must complete requirements Deadline: November 30
Prescription Drug – Express Scripts No plan change to prescription drug benefits Network continues to include Walgreens and Dierbergs
2015 Medical Plan Options
Plus Plan QHDHP Plan
SLUCare In-Network Out-of-Network
SLUCare In-Network Out-of-Network
Deductible Non-Embedded: (One member can satisfy entire family deductible)
Individual $0 $500 $750 $1,500 $1,500 $3,000
Family $0 $1,000 $1,500 $3,000 $3,000 $6,000
Coinsurance 0% 10% 40% 0% 10% 40%
Out-of-Pocket Maximum (includes deductibles and all copays) Non-Embedded: (One member can satisfy entire family OOP Max)
Individual $1,500 $1,500 $4,750 $1,500 $3,000 $6,000
Family $3,000 $3,000 $9,500 $3,000 $6,000 $12,000
Physician Office Visits
Primary Care $10 copay10% after ded. 40% after ded. 0% after ded. 10% after ded. 40% after ded.
Specialist Care $20 copay
Preventive Care 100% 100% 100% 100% 100% 100%
Inpatient Hospital
N/A 10% after ded. 40% after ded. N/A 10% after ded. 40% after ded.
Emergency Room
N/A $100 copay $100 copay N/A 10% after ded. 10% after ded.
Urgent Care Center
N/A $50 copay $50 copay N/A 10% after ded. 40% after ded.
2015 Pharmacy Plan Options
Plus Plan QHDHP Plan
Express Scripts
Retail
(34-day supply)
Express Scripts
Mail Order
(90-day supply)
Express Scripts
Retail
(34-day supply)
Express Scripts
Mail Order
(90-day supply)
Tier 1 $8 $16 Medical Deductible and Coinsurance
Tier 2 $30 $60 Medical Deductible and Coinsurance
Tier 3 $50 $100 Medical Deductible and Coinsurance
Tier 4 20% to $150 N/A Medical Deductible and Coinsurance
Preventive Medications Priced according to the tier in which they fall Covered at 100%, no copay or deductible
Under the QHDHP, certain preventive, or “maintenance,” medications are covered at 100%... No deductible or
coinsurance!
2015 Cost Sharing
No change to rates!!! Premium has remained the same for 3 years!
Wellness Incentive remains at $50 for employee only coverage and an additional $25 for spouse coverage (all or nothing discount)
Plan Monthly Premium Deductions With Monthly Wellness Discount
Plus Plan
Employee Only $143.79 $93.79
Employee and Spouse $386.97 $311.97
Employee and Child(ren) $332.25 $282.25
Family $520.66 $445.66
QHDHP Plan
Employee Only $79.64 $29.64
Employee and Spouse $252.24 $177.24
Employee and Child(ren) $210.36 $160.36
Family $328.20 $253.20
Plus Plan – Employees earning up to $33,000
Employee Only $50.00 $0
Employee and Spouse $293.18 $218.18
Employee and Child(ren) $238.46 $188.46
Family $426.87 $351.87
2015 Cost Sharing
Bi-Weekly Premiums
Plan Bi-Weekly Premium Deductions With Bi-Monthly Wellness Discount
Plus Plan
Employee Only $66.36 $43.28
Employee and Spouse $178.60 $143.98
Employee and Child(ren) $153.35 $130.27
Family $240.30 $205.68
QHDHP Plan
Employee Only $36.76 $13.68
Employee and Spouse $116.42 $81.80
Employee and Child(ren) $97.09 $74.01
Family $151.48 $116.86
Plus Plan – Employees earning up to $33,000
Employee Only $23.08 $0
Employee and Spouse $135.31 $100.70
Employee and Child(ren) $110.06 $86.98
Family $197.02 $162.40
Health Savings Account
Annual Enrollment 2015
Health Savings Accounts
Health Savings Accounts (HSAs) are designed to help you save and pay for your healthcare now and when you retire
Triple tax savings: Put money in pre-tax Grow your savings tax free Pay for qualified medical expenses income tax free
Account is always yours
HSA Eligibility for Account Holders only
You are eligible to open and contribute to an HSA if you:
If you don’t meet one of these eligibility requirements, you can still enroll in the QHDHP plan, you just cannot open and contribute to a Health Savings Account
Are covered by a Qualified High Deductible Health Plan (QHDHP)
Are not covered by any other health plan that is not a QHDHP
Are not enrolled in Medicare, Medicaid, or TRICARE
Have not received VA benefits within the past 3 months
Are not claimed as a dependent on someone else’s tax return
Are not covered by a Health FSA(Must have $0 in your Health FSA before contributing to an
HSA)
HSA Contributions
2015 Maximum Contribution Limit
* 2014 Limits: $3,300 for Individual, $6,550 for Family
IRS maximum reflects a combined employer + employee contribution
55+ can fund an additional $1,000/year; “catch-up” contribution
Please note SLU will only put seed money into an OptumHealth administered HSA. If you choose to go to a financial institution of your choice, then you will not receive the seed money.
HSA must be established by November 30 in order to receive seed money on January 1
Funds must physically be in your account before disbursements can be made
Any money remaining in the account at the end of the calendar year rolls over into the next year
2015 IRS Maximum SLU Seed Money
Individual $3,350 $250
Family $6,650 $500
Taking Money OUT of an HSA
Issues in Distributions Reimbursement of expenses for employee, spouse and Tax Code dependents
are tax free Expense must be incurred on or after the date the HSA was established
Qualified expenses include: Health, dental and vision expenses COBRA premiums Medicare premiums Qualified long-term care premiums Retiree health insurance after age 65, but not Medigap/Supplement plans
Other withdrawals are taxable Income tax, plus… Subject to 20% excise tax if withdrawn prior to age 65 After you turn 65, or enroll in Medicare, you may withdraw money for non medical purposes
without a penalty. The withdrawal is treated as retirement income and is subject to normal income tax.
It is important to save your receipts in case you are audited by the IRS Account is between you and the IRS; OptumHealth bank does not substantiate your
claims
HSA & FSA Participation
IRS guidelines prohibit participants from contributing to a Health Care FSA and an HSA at the same timeSpouses are ineligible to participate in their employer’s Health Care
FSA Ok if a Limited FSA – used for dental and vision expenses only
In order for you to fund an HSA on January 1, there must be a $0 balance in your Health Care FSA on December 31
You can still enroll in the benefit plan, but cannot contribute to an HSA account
Making Deposits
Payroll Deduction
Arrange for an automatic payroll deduction into your account
Mail a CheckMake a deposit at any time on OptumHealth from your checking or savings account
e-ContributeArrange a regular electronic transfer from an account at another financial institution
Access Your HSA Funds
Use your UnitedHealthcare Health Savings Account Debit MasterCard®
Sign up for automatic bill pay and online banking
Use HSA checks
Pay with personal funds and reimburse yourself from your HSA
myuhc.com
Benefit summaries
Deductible accumulator
Treatment cost estimator
Check statements
Pay bills to health care providers
Update personal information
Learn about QHDHPs and HSAs
HSA calculators
Additional Programs
UnitedHealthcare:
Diabetes Prevention and Control Pre-diabetics work with YMCA lifestyle coaches to prevent the progression Diabetics work with Shop N’ Save pharmacists face-to-face to help control and
improve prescription compliance, set goals, and review lab work
Diabetes Health Plan Members incentivized to comply with recommended Medical and Rx guidelines Plus Plan: No office visit or pharmacy copays for diabetes-related eligible
expenses Available only when using SLUCare physicians
Vitality
Annual Enrollment 2015
www.powerofvitality.com
Earn points by: Review and activate your personal health goals Update or confirm your email contact information Complete an online Course to learn about a health topic Complete a Vitality Check™ biometric screening with a Vitality partner Schedule Healthy Habits and Preventive Screenings Track your workouts using a Vitality-approved fitness device Sign up at a Partner Health Club Get CPR or first aid certified
Once you build up your points, go spend them! Rewards in the Vitality Mall:
Amazon Gift Cards Hotel discounts to Hyatt iTunes gift cards Movie theater ticket vouchers Fitbits, Fitbugs, Garmin, and Polar devices Charity
Please note: This list does not cover the program in its entirety. Please refer to the web site for complete program activities, rules and details.
Voluntary Dental Benefits
Annual Enrollment 2015
Voluntary Dental Benefits
Coverage will remain with Delta Dental
Choose among two dental plan options
Both plans include Delta’s PPO and Premier dentists
Option 1: Flex Plan No benefit changes
Last year the maximum was increased from $1,000 to $1,500
Option 2: Basic Plus No benefit changes
Combination of previous Basic Plus and Basic Plan Both in and out of network benefits
Voluntary Dental Plan—Delta Dental
Flex Option Basic Plus
PPO Network Out-of-Network PPO Network Only Out-of-Network
Deductible
Individual $50 $50 $25 $25
Family $150 $50 $75 $75
Calendar Year Maximum
Per person $1,500 $1,500 $1,000 $1,000
Preventive Care (Member Responsibility Shown)
0% no deductible 0% no deductible 0% no deductible 50% no deductible
Basic Restorative Care ( Member Responsibility Shown)
10% after deductible 30% after deductible 30% after deductible 65% after deductible
Major Restorative Services (Member Responsibility Shown)
40% after deductible 60% after deductible 60% after deductible 80% after deductible
Orthodontia
Lifetime maximum (per person) $1,000 $1,000 $1,000 $1,000
Orthodontia 50%
For adults and children to age 26
60% For adults and
children to age 26
50%For children to age 19
only
75%For children to age
19 only
2015 Dental Contributions
Flex Basic Plus
Monthly
Single $36.01 $21.07
Two-person $70.49 $40.52
Family $120.69 $72.60
Bi-Weekly
Single $16.62 $9.72
Two-person $32.53 $18.70
Family $55.70 $33.51
Voluntary Vision Benefits
Annual Enrollment 2015
Voluntary Vision Benefits
New benefit this year! (Non-Union employees only)
Offered through Vision Service Plan (VSP)
Plan includes benefits for eye exam, frames, contacts, etc.
In-Network vs. Out-of-Network In-Network = no claim forms to completeOut-of-Network = must submit claim form for reimbursement
VSP.comFind a provider
Network: ChoiceRegister and review benefit informationDiscounts availablePrint an ID card (not necessary to use benefits)
Plan is 100% employee paid
Voluntary Vision Plan—VSP
Vision Plan
In-Network Out-of-Network
Exam
Wellvision Exam $10 copay Up to $45 allowance
Lenses
Single $10 copay Up to $30 allowance
Bifocal $10 copay Up to $50 allowance
Trifocal $10 copay Up to $65 allowance
Frames
$150 allowance for a wide selection of frames; $170 allowance for
featured frame brands; 20% on the amount over your balance
Up to $70 allowance
Contacts (in lieu of glasses)
$150 allowance for contacts; including the contact lens exam
(fitting and evaluation)Up to $105 allowance
Frequency
Exam/Lenses/Contacts (in lieu of glasses)
Every calendar year
Frames Every other calendar year
2015 Vision Contributions
Vision Plan
Monthly
Employee Only $7.02
Employee and Spouse $12.76
Employee and Child(ren) $13.38
Family $20.33
Bi-Weekly
Employee Only $3.24
Employee and Spouse $5.89
Employee and Child(ren) $6.18
Family $9.54
Voluntary Accident Benefits
Annual Enrollment 2015
Voluntary Accident Benefits
New benefit this year! (Non-Union employees only)
Offered through Voya Financial (formerly ING)
Plan reimburses expenses that occur due to an accident
Coverage is guarantee issue – no health questions asked
No “Network”
When you have an expense, you must submit a claim form; reimbursement will then be mailed as a check
24-hour coverage – accidents on or off the job are eligible
Plan is 100% employee paid
Voluntary Accident Plan—Voya
Service Benefit Amount
Accident Hospital Care
Surgery (open abdominal, thoracic)
$1,200
Hospital Confinement $250/day up to 365 days
Coma (14 or more days) $6,000
Follow-Up Care
Medical Equipment $120
Physical Therapy $30/treatment (6 max)
Prosthetic Device $6,000
Emergency Care
Ground Ambulance Transport $120
Air Ambulance Transport $600
Emergency Room Treatment $180
Common Injuries
Burns, Laceration, Torn Knee Cartilage, Paralysis, Tendon/Ligament/Rotator Cuff
Varies
Service Benefit Amount
Common Injuries – Dislocations
Hip Joint $2,400/$4,800
Knee $1,200/$2,400
Shoulder $360/$720
Common Injuries – Fractures
Hip $1,800/$3,600
Leg $960/$1,920
Ankle $360/$720
Kneecap $360/$720
Nose $120/$240
Other Benefits
Wellness Benefit(completion of health screening test)
$100/employee or spouse$50/child (max of 4)
Sickness Hospital Confinement Benefit
$100/day for employee or spouse
$75/day for children
Below is a sample list of benefits, it does not include all the benefits available under the policy.
2015 Accident Contributions
Accident Plan
Monthly
Employee Only $24.74
Employee and Spouse $41.90
Employee and Child(ren) $39.62
Family $56.78
Bi-Weekly
Employee Only $11.42
Employee and Spouse $19.34
Employee and Child(ren) $18.29
Family $26.21
Flexible Spending Accounts
Annual Enrollment 2015
Flexible Spending and Dependent Care Accounts
Administration will remain with ConnectYourCare
You must make a new election for the 2015 plan year; current elections cannot be carried forward
Debit card allows direct payment Eases payment, but does not substantiate claims – receipts may still be
needed! Use at authorized vendors (medical facilities, hospitals, pharmacies, etc.)
Remember if you are electing the QHDHP plan and open an HSA, the IRS requires your Health FSA balance to be $0.00 on January 1, 2015 before contributing to an HSA
Flexible Spending and Dependent Care Accounts
Due to health reform, annual maximum for the Health FSA will be remain at $2,500
Annual maximum for the Dependent Care Account will remain at $5,000 ($2,500 if married and filing separate returns)
For the Health FSA Total election amount less previous reimbursements is available at the time
of transaction
For the Dependent Care FSA Only the cash balance in your account is available at the time of transaction
You cannot roll over unused balances from one year to the next Use it or lose it rule applies
Eligible Medical FSA Expenses
Copays, coinsurance and deductibles for medical, prescription and dental plans
Eye exams, contacts and eyeglasses
Laser eye surgeries
Hearing aids
Over-the-counter medical supplies Bandages, splints, contact lens solution, etc.
Over-the-counter medical medications must be accompanied by a prescription
Insulin
Some expenses not covered by your medical plan
Annual Enrollment 2015
2015 Annual Enrollment
Plan elections are binding for the 2015 plan year, unless you experience a qualifying life event:
Marriage Birth/adoption Divorce Death Change in employment status Change in dependent status
Life status changes allow you to make benefit election changes
The Benefits Department must be notified within 31 days of life change
2015 Annual Enrollment
Enrollment season is November 1 through 30
If making changes, do so through Banner Self-Service Current medical and dental elections will carry forward Must actively enroll in vision and accident plans, if interested New and existing HSA, Dependent Care and Health FSA participants will
need to make an election for 2015. Current deductions will not carry forward.
New HSA participants will also need to establish an OptumHealth bank account by November 30 in order to receive seed money
Update beneficiary information if necessary
All enrollment elections must be completed online no later than Sunday, November 30, 2014 Benefits Office will be closed Thursday, November 27 and Friday, November
28
Contact benefits@slu.edu or wellness@slu.edu with questions!
Questions?
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