spring tour 2016 actives
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TM
ANNUAL BENEFIT
ELECTION PERIOD
For the FY2017 benefit year
July 1, 2016 – June 30, 2017
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Spring Tour 2016
Montana University System
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Agenda for Today
Important Changes for FY2017
1. Mid-Year Change Recap
2. Rehabilitation Benefit Changes
3. Medical Flexible Spending Account (FSA), Tax
Advantaged Account (TAA), and Wellness reminders
Benefit Changes and your Decisions for FY2017
1. Medical, Dental, and Vision
2. Rates and Fees
Time Frames for Making Benefit Change Decisions
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Important Changes for FY2017
MID-YEAR CHANGE RECAP
BENEFIT DESCRIPTIONBENEFIT THROUGH
DECEMBER 30, 2015
CHANGE AS OF
DECEMBER 31, 2015
Copayments
Office Visits (non-specialty) $15 $25
Specialty Visits $15 $40
Emergency Room Facility
Visits
$125 $250
Urgent Care Visits $50 $75
URx Copays Tier A (retail/mail) $0/$0
Tier B (retail/mail) $15/$30
Tier C (retail/mail) $40/$80
Tier D (retail/mail) 50 %
Tier F (retail/mail) 100%
Tier A (retail/mail) $0/$0
Tier B (retail/mail) $25/$50
Tier C (retail/mail) $60/$120
Tier D (retail/mail) 50 %
Tier F (retail/mail) 100%
URx Specialty Copays Specialty $50/ Specialty $200 Specialty $150/ Specialty $300
Deductible
Increase In-Network
Deductible
$500 (individual)/$1,000 (family) $750 (individual)/ $1,500 (family)
Out-of-Pocket Maximums
Increase In-Network Medical
OOP
$3,500 (individual)/$7,000 (family) $4,000 (individual)/$8,000 (family)
Increase Rx Out-of-Pocket $1,650 (individual)/$3,300 (family) $2,150 (individual)/$4,300 (family)
Other Benefit Adjustments
Infertility Treatment Covered – see Summary Plan
Description for details
Not covered – plan exclusion
Vision Hardware Benefit See full description at
www.choices.mus.edu/Vision.asp
$300 frames and lenses maximum
annual allowance , in lieu of contacts
$150 contacts maximum annual
allowance, in lieu of frames and
lenses
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Important Changes for FY2017
REHABILITATION BENEFIT
CHANGES
Rehabilitative Services will be expanded to
include Acupuncture and Chiropractic Services.
BENEFIT DESCRIPTIONIN-NETWORK
COPAY/COINSURANCE
OUT-OF-NETWORK
COPAY/COINSURANCE
REHABILITATIVE SERVICES
Inpatient Services
(Pre-certification is strongly
recommended)
25% 35%
Max: 30 days per year (all therapies combined)
Outpatient Services$25 copay /visit 35%
Max: 30 visits per year (all therapies combined)
Covered Rehabilitative Services Include:
Physical Therapy
Occupational Therapy
Speech Therapy
Cardiac Rehabilitation
Respiratory Rehabilitation
Pulmonary Rehabilitation
Acupuncture
Chiropractic
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Important Information for FY2017
Selection Of Medical Plan - WE WILL
CONTINUE OFFERING THREE MEDICAL
PLAN OPTIONS IN FY2017
Allegiance Managed Care
Blue Cross and Blue Shield
Managed Care
Pacific Source Managed Care
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Important Information for FY2017 (cont.)
Use In-Network Providers – Be sure to use
In-Network providers to ensure you do not
incur “balance billing” charges.
Network participation by
providers is changing in the
health care market.
Always check - DO NOT assume
participation “….but my doctor has
always been In-Network!”
Check with your medical plan vendor,
MUS Benefits Office, or your campus if
you need help finding In-Network
providers.
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Important Information for FY2017 (cont.)
ELIGIBILITY
Dependents up to age 26 may enroll
annually in medical, dental, and vision
benefits. (Does not include spouses)
Proof of eligibility according to
criteria in the Summary Plan
Description will be required.
Mid-year disenrollment may only
occur with a “qualifying event” or
during a “Special Enrollment Period”.
MEDICAL FLEXIBLE SPENDING ACCOUNT
REMINDERS…
Only employee contributions may be made to the
Medical Flexible Spending Accounts (FSAs).
The maximum amount an employee can deposit
to a medical FSA in FY2017 will be $2,550.
Medical FSAs are coordinated with your Tax Advantage
Account (TAA) account.
Funds are expended from the FSA first (since FSAs are
“use-it-or-lose-it”) and then from the TAA.
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Important Information for FY2017
MEDICAL FLEXIBLE SPENDING
ACCOUNTS FY2017
$500 Annual FSA Roll-Over
If you have funds remaining in your
FSA account as of June 30, 2016, the
rollover provision allows you to:
1. Carry up to $500 forward into the following plan year
(for use beginning July 1, 2016) in your FSA. These
funds will be placed in the FSA in October 2016 after
FY2016 reconciliation is completed.
2. You may expend these funds on qualifying medical
expenses incurred during the following plan year
from your FSA.10
Important Information for FY2017 (cont.)
TAX ADVANTAGED ACCOUNTS (TAAs)
FY2017
Tax Advantaged Account (TAA) things to know… Only employer funds can be placed in a TAA; employee
funds cannot be contributed (use the FSA instead).
If your spouse has coverage through a HAS (Health Savings Account) or
has a High-Deductible health plan, you may wish
to talk to a tax advisor about whether to elect the
TAA.
An employer contribution to the TAA will not be made
for FY2017. Wellness Incentives earned by employees
participating in the MUS Wellness program will be made to the TAA.
(Note: participants must elect the TAA each year.)
Account balances are not use-it-or-lose-it and can continue up to 24
months following the last day of employment with MUS (for terminating or
retiring employees) and up to 24 months following the date that MUS
ceases to make employer contributions (including Wellness Incentives).11
Important Information for FY2017 (cont.)
MEDICAL SPENDING ACCOUNTS FY2017
WELLNESS INCENTIVE Active employees who completed a
WellCheck (biometric screening,
HRA, and blood draw) during calendar
year 2015 and achieved the Trailblazer
level will receive a $250 Wellness
incentive contribution to their TAA .
Adult dependents completing a WellCheck during
calendar year 2015 will receive an additional $250 in
the TAA.
Maximum of $500 per individual household enrolled in
the MUS Plan.
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Important Information for FY2017 (cont.)
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Important Information for FY2017 (cont.)
LIFE INSURANCE ELECTIONS
Evidence of Insurability is Required When:
1. An Active employee wishes to add Optional Supplemental Life
Insurance in an amount above $300,000 or increase existing
coverage more than one increment of $25,000 annually.
2. Adding Optional Supplemental Dependent Life
for a spouse if not enrolled during the new hire election.
Optional Supplemental Life and
Optional AD&D Coverage premiums
are paid on an after-tax basis.
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Important Changes for FY2017 (cont.)
OPTIONAL
VISION HARDWARE
BENEFIT
Optional Vision Hardware Benefit covers ONLY
hardware.
Eyeglass frames and lenses, in lieu of contacts.
UP TO $300 ANNUAL ALLOWANCE.
Contacts, in lieu of frames and lenses.
UP TO $150 ANNUAL ALLOWANCE
Eye Exam is provided as part of the medical plan.
No need to use a network for purchasing hardware
– simply select a place to purchase the frames,
lenses, or contacts and then submit claims to Blue
Cross and Blue Shield.
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Benefit Changes
and
Your Decisions for FY2017RATES AND FEES
ACTIVE MEDICAL –• 19.9% Aggregate Increase• Employer contribution increases to $1,054 from $887 per month.
• Premium changes after the employer contribution are applied range from a
decrease of $28 to an increase of $50 per month depending on which medical
plan you select and whether you cover dependents.
ACTIVE DENTAL –• Rates increase by 2.5% or $1-$3 per month.
• Benefits are unchanged.
OPTIONAL VISION HARDWARE PLAN –• Rates increase by 5.2% or $0.37-$1.07 per month.
• Remember – the Medical Benefits cover vision exams!
• Optional Vision Hardware Plan covers eyeglass frames and lenses or
contacts
Health Plans and Networks
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To receive your best benefits,
STAY IN-NETWORK
with your health plan
Allegiance 1-877-778-8600, www.abpmtpa.com/mus
Blue Cross and Blue Shield 1-800-820-1674,
www.bcbsmt.com
PacificSource 1-877-590-1596,
www.PacificSource.com/MUS
Changes to CHOICES Please watch for campus mailings/information regarding key
dates benefit changes must be submitted by.
Reminder - Closed enrollment for spouses in FY2017 (qualifying
event required to add spouses – children up to age 26 may be
added).
If you do not submit any changes, then you will be re-enrolled in
the prior year benefit elections (except for Flex or TAA).
FLEX PLAN ENROLLMENT and TAA ELECTION1. You must re-enroll in Flex each year and specify the dollars you
wish to go into your account.
2. Remember that Flex is USE IT OR LOSE IT! – Rollover provision
permits up to $500 to carry forward to the following year.
3. TAA must be elected by employee annually – must elect TAA to
be eligible for Wellness funds.
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QUESTIONS?
Thank you for your time!
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