early retiree plan benefit options
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Early Retiree Plan Benefit Options . 2013 - 2014. Statewide, Nationwide, and Around the World. Blue Plans represents the nation’s largest and most experienced health care benefit companies . - PowerPoint PPT PresentationTRANSCRIPT
Early Retiree Plan Benefit Options
2013 - 2014
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Statewide, Nationwide, and Around the World• Blue Plans represents the nation’s largest
and most experienced health care benefit
companies.
• Blue Plans cover 100 million people—
nearly one-third of all Americans—in all
50 states, the District of Columbia and
Puerto Rico.
• Blue Cross and Blue Shield of Nebraska
insures or provides
benefit administration for more
than 700,000 people. BLUE CROSS AND BLUE SHIELD OF NEBRASKA
92% Physicians
96% Hospitals
Members have access to:
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IntroductionsNSEA-Retired President - Roger ReaUnion Bank - Bobbi HaniganEHA Field Representative - Greg Long Blue Cross Blue Shield of NebraskaKent Trelford-ThompsonSue WarnerTara StevensonLinda FarahaniNick Stoysich
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AgendaPlan and RatesBenefit Plan Options
$750 Deductible PPO$1,650 Deductible PPO$3,100 Deductible High Deductible Health Plan$4,000 Deductible High Deductible Health Plan
Health Savings AccountsHow to Enroll
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2013 – 14 Rates for Early RetireesEHA Early Retiree Rates
Benefit Option Employee Employee + Children
Employee + Spouse
Family
$750 Deductible $566.28 $1,003.86 $1,189.19 $1,503.22
$1,650 Deductible $477.79 $846.98 $1,003.35 $1,268.30
$3,100 Deductible $477.79 $846.98 $1,003.35 $1,268.30
$4,000 Deductible $424.71 $752.90 $891.89 $1,127.41
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Early Retiree Rate Comparison EHA Early Retiree Rates
Benefit Option Employee Employee + Children
Employee + Spouse
Family
$750 Deductible $566.28 $1,003.86 $1,189.19 $1,503.22
$1,650 Deductible$3,100 Deductible
$477.79 $846.98 $1,003.35 $1,268.30
Premium Difference to $750 Plan
$88.49 $156.88 $185.84 $234.92
$4,000 Deductible $424.71 $752.90 $891.89 $1,127.41
Premium Difference to $750 Plan
$141.57 $250.96 $297.30 $375.81
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$750 Deductible PPO Option Deductible:
$750 Employee only or $1,500 FamilyCoinsurance 80% - 20%:
$2,250 Employee only or $4,500 FamilyOffice Visit Copay:
$30 – Primary Care Physician $50 - Specialist$50 – Ded & Coins - Urgent Care$75 – Ded & Coins - Emergency Room
Routine Care Benefit:Expanded Benefits due to Affordable Care Act
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)
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$1,650 Deductible PPO Option Deductible:
$1,650 Employee only or $3,300 FamilyCoinsurance 70% - 30%:
$3,250 Employee only or $6,500 FamilyOffice Visit Copay:
$45 – Primary Care Physician $65 - Specialist$65 – Ded & Coins - Urgent Care$90 – Ded & Coins - Emergency Room
Routine Care Benefit:Expanded Benefits due to Affordable Care Act
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)
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$3,100 Deductible: High Deductible Health Plan Deductible:
$3,100 Employee or $6,200 FamilyCoinsurance 100% - 0%:
$0 Employee only or $0 FamilyOffice Visit Copay:
Primary Care Physician – Applies to Deductible Specialist - Applies to DeductibleUrgent Care – Applies to Deductible Emergency Room – Applies to Deductible
Routine Care Benefit:Expanded Benefits due to Affordable Care Act
Pharmacy Benefit :Generic – Applies to DeductibleFormulary Brand - Applies to DeductibleNon-Formulary Brand – Applies to Deductible
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$4,000 Deductible : High Deductible Health PlanDeductible:
$4,000 Employee only or $8,000 FamilyCoinsurance 70% - 30%:
$2,350 Employee only or $4,700 FamilyOffice Visit Copay:
Primary Care Physician – Applies to Deductible & Coinsurance Specialist - Applies to Deductible & Coinsurance Urgent Care – Applies to Deductible & Coinsurance Emergency Room – Applies to Deductible & Coinsurance
Routine Care Benefit:Expanded Benefits due to Affordable Care Act
Pharmacy Benefit :Generic – Applies to Deductible & Coinsurance Formulary Brand - Applies to Deductible & Coinsurance Non-Formulary Brand – Applies to Deductible & Coinsurance
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What is a Health Savings Account
A health savings account (HSA) is a tax-advantaged medical savings account available to taxpayers in the United States who are enrolled in a high deductible health plan (HDHP). The funds contributed to an account are not subject to federal income tax at the time of deposit. HSA’s are owned by the individual and funds may be used to pay for qualified medical expenses.
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Please Welcome
Bobbie Hanigan Union Bank
HEALTH SAVINGS ACCOUNTS
Presented by:
Bobbi Hanigan Union Bank & Trust Company
Benefits of an HSA • You see the true cost of medical care and have better
control over how your dollars are spent• Funds roll over from year to year• There is no “use it” or “lose it”• Funds belong to you - regardless
Who Can Open aHealth Savings Account?
• Age Requirement: 18 or older• Must be enrolled in a qualifying High Deductible Health Plan
(HDHP)• Cannot be covered by any non-qualified HDHP Health
Insurance• Account is owned by the insured• Unused Funds may roll over to next plan year and beyond• Cannot be enrolled in Medicare• Cannot be claimed as a dependent on another individual’s tax
return
2013 HSA Contributions• Maximum annual contribution amount for 2013 is:
- $3,250 Individual coverage- $6,450 Family Coverage
• 2013 Catch-up Contributions for HSA owners ages 55+ - $1,000 for 2009 and thereafter ****if the account owner has a spouse who is covered
under the HDHP, and they are 55+ ---they qualify to make the catch-up contribution – this contribution would need to be into their own account!
2014 HSA Contributions• Maximum annual contribution amount for 2014 is:
- $3,300 Individual coverage- $6,550 Family Coverage
• 2014 Catch-up Contributions for HSA owners ages 55+ - $1,000 for 2009 and thereafter ****if the account owner has a spouse who is covered
under the HDHP, and they are 55+ ---they qualify to make the catch-up contribution – this contribution would need to be into their own account!
HSA Contributions (continued)• Contributions can be made as late as April 15 of the following
year• Anyone can contribute to an HSA for you• Contributions are Tax deductible (unless made by your
employer)• Tax-Free earnings through investments/interest• Excess Contributions must be withdrawn and taxed as
ordinary income plus an additional 10% excise tax
HSA Distributions• Distributions for qualified medical, dental or vision expenses
are not taxed
• Non-qualified expenses are taxable as ordinary income plus an additional 20% penalty
(exceptions: individual’s death, disability or reaching age 65)
• Distributions for non-qualified expenses taken after age 65 are taxed current tax rate and are NOT subject to the 20% penalty
What Medical Expenses Qualify?• Prescriptions and qualified deductible expenses• Qualified long-term care services and a percentage of long
term care insurance premiums • COBRA premiums• Health insurance for those on unemployment compensation• Eye Exams• Dental Exams
Advantages of HSAs• Triple Tax Savings:
Tax deductions when you contribute to your accountTax-free earnings through investments/interestTax-free withdrawals for qualified medical expenses
• Portability-accounts are completely portable if you: Change your medical coverage
Move to another stateChange your marital status
HSA Beneficiaries• Surviving spouse becomes the owner of the account and can
use it as if it were their own HSA
• No surviving spouse? The account is no longer treated as an HSA. The account passes to your beneficiary, or becomes part of your estate (and is subject to any applicable taxes)
Two Types of Accounts to Meet Your Savings and Investment Needs
Deposit HSA• Variable Balance• High Activity• Easily Accessible• Online Bill Pay• FDIC Insured Account
Mutual Fund Account• Growth-oriented account• Low level of activity• Higher balances• Online Management• Not FDIC Insured!
Accessibility The balances in your Deposit HSA Account are
immediately accessible using your:• HSA Debit Card
• Online BillPay
• Checks-you may choose to purchase checks for your account!
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Online Bill Pay
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http://www.onlinebanktours.com/oec/?b=209&c=15657
HSA Enrollment Process for Deposit HSA Account
Union Bank & Trust is excited to announce…….E-Signature!!!!
• Simply log onto www.ubt.com • Select “Open Account Online” (middle of left side)• Select Health Savings Account (bottom of left side)• Complete application as instructed • Remember to Select “EMPLOYER SPONSORED PLAN”• Account is opened and you will receive your account number
at this time! Remember to record it for future reference.
Health Savings AccountsEncourage Healthy Living
• Preventative care is not a deductible expense and is covered at 100% by your CDHP
• Proactive approach to health care
• The money that you do not use in the account is yours to keep – an incentive to live a healthy lifestyle
Account Owner Responsibility• If you have specific tax questions, please consult your tax
professional• Union Bank & Trust is not responsible for monitoring the
account for proper usage• Please remember that when used properly, the Health
Savings Account offers Triple Tax Savings!! Tax-Free Contributions, Tax-Free Earnings, and Tax-Free Qualified Distributions
• It is the Account Owner’s responsibility to maintain all records and receipts for the account
Union Bank & Trust HSA Contact
Bobbi Hanigan Heather Poysa (402) 323-1482 (402) 323-1351
[email protected] [email protected]
Toll Free: [email protected]
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Examples of Out-of-Pocket Cost’s Hypothetical Out-of-Pocket Expense
$750 PPO
$1,650 PPO
$3,100 HDHP
$4,000 HDHP
Allowable Charge is
$750
Members Cost Share $750
Members Cost Share $750
Members Cost Share $750
Members Cost Share $750
Allowable Charge
is $1,650
Ded = $75020% of $900=
$180$930
Members Cost Share
$1,650
Members Cost Share $1,650
Members Cost Share
$1,650
Allowable Charge is $35,000
Ded = $750Coins = $2,250
$3,000
Ded = $1,650Coins = $3,250
$4,900
Ded = $3,100 Ded = $4,000Coins = $2,350
$6,350
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Not Another Knee Injury Hypothetical follow-up to $35,000 Inpatient Hospital Claim
Hypothetical Expense
$750 Deductible $1,650 Deductible $3,100 HDHP
$4,000 HDHP
Inpatient Expense $3,000 $4,900 $3,100 $6,350
Follow-up Specialist Office Visit (2)
($50 x 2)$100
($65 x2)$130
Ded Ded & Coins
Prescription Formulary
Brand-Name
($200 x 25%)$50
($200 x 30%)$60
Ded Ded & Coins
Physical Therapy 6 Visits
Ded & Coins Ded & Coins Ded Ded & Coins
Follow-Up Office Visit
PCP
$30 $45 Ded Ded & Coins
Total OutOut-of-Pocket
$3,180 $5,135 $3,100 $6,350
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Key Points to Remember• To request an application please contact the Lincoln BCBSNE office at
(402)458-4800• Application Deadlines:
– For January 1, 2014 effective date; all applications due to the Lincoln BCBSNE office no later than Monday December 2, 2013.
• Single Dental coverage is required with all plans.• If you move to on of the higher deductible plans, you must stay on that
option for 3 years or until you reach age 65, which ever comes first. • Health Savings Accounts provide a Triple Tax Savings.• If a member elects to move to the Federal Market Place, the member
would not be able to return to Direct Bill Coverage.• Member Service Number 1-877-721-2583.• Once you have sent your application to BCBSNE all question should be
referred to Member Services.
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QUESTIONS