open enrollment presentation january 2010. agenda changes to bigband’s benefit programs overview...

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Open Enrollment Presentation January 2010

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Open Enrollment Presentation

January 2010

Agenda

Changes to BigBand’s Benefit Programs Overview of Plans What You Need to Do Important Paperwork Life Changes

Overview of Benefits Programs

The following slides are condensed overview of BigBand’s benefits

For details, please consult providers’ plan documents

Filice Insurance Services/Resources

Dedicated Account Management team

Eric Pogue – 925-299-7212; [email protected]

Chris Kelly – 925-299-7216; [email protected]

Alaina Kelly – 925-299-7213; [email protected]

Assistance with claims, eligibility, forms, carrier issues, etc.

Customized benefits website: www.filice.com/benefits/bigband

Blue Shield HMO Plan Design Blue Shield HMO

Deductible (facility deductible) $1,500 per member

Co-payment maximum $2,000 per member

Primary Care Physician Visits $15 (deductible does not apply)

Routine physicals / well-child $15 (deductible does not apply)

No cost for vision / hearing screenings or medically necessary immunizations

Emergency $100 (Waived, if admitted)

Outpatient Surgery Facility deductible, then $100 / surgery

Hospitalization Facility deductible, then 10%

Prescription (Mail Order = 2 times these co-pays for up to a 90-day supply)

Generic $10 (deductible does not apply)

Brand Formulary *** $25 (deductible does not apply)

Non-Formulary *** $40 (deductible does not apply)

*** $250 Calenday-year Brand-name Drug Deductible

What is a deductible reimbursement plan? (Commonly referred to as a Health Reimbursement Account)

A company-sponsored deductible reimbursement plan. Reimburses employees and their dependents for any

allowable medical expenses under the company sponsored plan

Set up in accordance with IRS Code Section 105: medical reimbursements to employees are not considered taxable income to the employees or their dependents.

Kaiser HMO (HRA) Plan Design Kaiser HMO (HRA)

Deductible $2,000 self only & one member in a family of 2, or more

Deducbile $4,000 for an entire family of 2, or more members

Co-payment maximum $4,000 self only & one member in a family of 2, or more

Co-payment maximum $8,000 for an entire family of 2, or more members

Primary Care Physician Visits $20 (after deductible)

Routine physicals $20 (deductible does not apply)

Well-child $10 (deductible does not apply)

Emergency 20% (after deductible)

Outpatient Surgery 20% (after deductible)

Hospitalization 20% (after deductible)

Prescription (Mail Order varies)

Generic $10 (deductible does not apply)

Brand Formulary $30 (deductible does not apply)

Blue Shield PPO Plan Design (HRA) Blue Shield (Shield Spectrum PPO Savings Plus 2250 Deductible Plan

Deductible: $2,250 / individual - $4,500 / family (in or out-of-network combined)

Out-of-Pocket Max. $3,000 / individual - $5,500 / family (in or out-of-network combined)

Co-Insurance 80% in-network – 50% out-of-network

Office Visit 20% in-network (after deductible) – 50% out (after deductible)

Preventive / well-child No charge (deductible does not apply) – Not covered out-of-network

Other covered non-preventive services subject to the deductible

Emergency 20% (after deductible) – in or out-of-network

Outpatient Surgery 20% in-network (after deductible) – 20% out (after deductible)

Hospitalization 20% in-network (after deductible) – 50% of $600 + excess

Prescription (Mail Order = 2 times these co-pays for up to a 90-day supply)

Generic $10 (you must meet your deductible before co-pays begin)

Brand Formulary $25 (you must meet your deductible before co-pays begin)

Non-Formulary $40 (you must meet your deductible before co-pays begin)

The BigBand Health Reimbursement Arrangement and the Comparative Costs

SINGLE EMPLOYEE Monthly premium costs:

$42.10 for the Blue Shield HMO $60.11 for Kaiser (HRA) $79.89 for the Blue Shield PPO (HRA)

Annual deductible exposure: $1,500 facility deductible for Blue Shield HMO $1,000 for Kaiser HRA (BigBand will fund up to the first $1,000 via the HRA) $1,000 for Blue Shield PPO (BigBand will fund up to the first $1,250 via the HRA)

Office Visits $15 (no deductible) for the Blue Shield HMO 20% for Blue Shield PPO (after deductible) BigBand funds $1,250 via HRA $20 for Kaiser (after deductible) BigBand funds $1,000 via HRA

Inpatient care exposure: $1,500 for the HMO $1,000 for Kaiser ($2,000 - $1,000 HRA funding) $1,750 for Blue Shield ($3,000 - $1,250 HRA funding)

The BigBand Health Reimbursement Arrangement and the Comparative Costs (for a family)

FAMILY Monthly premium costs:

$201.17 for Blue Shield HMO $180.32 for Kaiser (HRA) $228.84 for Blue Shield PPO (HRA)

Annual deductible exposure: $1,500 facility deductible (per member) for Blue Shield HMO $2,000 for Kaiser HRA (BigBand will fund up to the first $2,000 via the HRA) $2,000 for Blue Shield PPO (BigBand will fund up to the first $2,500 via the HRA)

Office Visits $15 (no deductible) for the Blue Shield HMO 20% for Blue Shield PPO (after deductible) BigBand funds $2,500 via HRA $20 for Kaiser (after deductible) BigBand funds $2,000 via HRA

Inpatient care exposure: $1,500 for the HMO $2,000 for Kaiser ($4,000 - $2,000 HRA funding) $3,000 for Blue Shield ($5,500 - $2,500 HRA funding)

Dental Plan Design Delta Dental PPO

Questions ? Call 1-800-765-6003

Provider Directory = www.deltadentalins.com

Services Deductible * $50 / individual - $150 / family

Annual Maximum $1,500

Co-Insurance In Out (Subject to Usual, Customary & Reasonable)

Preventive - 100% 100%

Basic - 90% 80%

Major - 60% 50%

Orthodontics (child only) 50% 50% ($1,000 Lifetime Maximum)

Pre-determination Review (Recommended for services > $300)

Dental Plan Design (Buy-up Option) Delta Dental PPO

Questions ? Call 1-800-765-6003

Provider Directory = www.deltadentalins.com

Services Deductible * $50 / individual - $150 / family

Annual Maximum $2,000 in-network / $1,500 out-of-network

Co-Insurance In Out (Subject to Usual, Customary & Reasonable)

Preventive - 100% 100%

Basic - 90% 80%

Major - 60% 50%

Orthodontics (adult & child) 50% 50% ($1,500 Lifetime In & $1,000 Lifetime Out))

Pre-determination Review (Recommended for services > $300)

Vision Plan Design Vision Service Plan

Questions ? Call 1-800-877-7195

Provider Directory = www.vsp.com

Services Co-pay $25 (does not apply to contacts)

Exams: Once every 12 months

Lenses: Once every 12 months

Frames ($120 allowance) Once every 24 months

Contact Lenses ($120 allowance) Once every 12 months

*** Laser Vision Correction Discounts ***

* See fee schedule for out-of-network benefits

Life/AD&D and Disability Sun Life

Questions ? Call 1-800-247-6875

Website = www.sunlife-usa.com

Life Insurance

1.5 times basic annual salary to a maximum of $375,000

Voluntary Life up to 5 times salary (maximum benefit = $500,000)

Disability

STD = 66 2/3% of weekly earnings to a maximum of $2,309 per week

7-day elimination period

LTD = 66 2/3% of monthly pay to maximum monthly benefit of $10,000

90-day elimination period

Employee Assistance Program

Employee Assistance Program

Need Assistance ? Call 1-877-327-4753

Website = www.guidanceresources.com

Company ID # ZB3042Q

Assistance with the following:

Confidential Counseling on Personal Issues

Legal Information, Resources and Consultation

Financial Information, Resources and Tools

Information, Referrals and Resources for Work-Life Needs

Online Information, Tools and Services

The Importance of Having a Will

Assist America Travel Assistance) Provides medical assistance when traveling more than 100 miles from home

Need Assistance ? Call 1-800-872-1414 in the United States

Need Assistance ? Call 301-656-4152 outside of the United States

Assistance with the following:

Medical Consultation and Evaluation

Hospital Admission Guarantee

Emergency Evacuation

Critical Care Monitoring

Medically Supervised Repatriation

Prescription Assistance

Care for minor children

Legal and Interpreter Referrals

Return Mortal Remains

Pension Dynamics (Flexible Spending) Questions ? Call 800-888-1998

Website = www.pensiondynamics.com

Medical Expenses

Medical Reimbursement Limit = $3,000

Eligible Expenses

Non-Eligible Expenses

Over-the-Counter Reimbursements

Dependent Care

$5,000 limit

Educational versus Custodial

Day Camp versus Overnight Camp

Voluntary Pet Insurance VPI Pet Insurance

Nation’s largest & oldest provider Plan is completely portable Discounts (5% core policies / 10% for 2-3 pets) Low deductible of $50 Vaccination & Routine Care coverage available Easy Enrollment

www.petinsurance.com/nbg 866-332-7620

Customer Care my.petinsurance.com 800-USA-PETS

Pre-Paid Legal Pre-Paid Legal plan

Telephone Conversations (unlimited) Letters/Phone Calls on your behalf (one per subject) Unlimited Document Review (10-pages per document)

Identity Theft Shield (Kroll Background America) Detailed Credit Report (Experian / FICO Score / Analysis Continuous Credit Monitoring (Daily)

Safeguard for Minors Children under age 18 Continuous Credit Monitoring

Liberty Mutual Auto & Home Voluntary Benefits Car Insurance

Liability Medical Payments / Personal Injury Uninsured / Underinsured Motorists Collision Comprehensive Mechanical Parts Replacement Car Windshield Repairs New Car Replacement

Homeowners Insurance Your Home Your Possessions Your Liability

Maximizing Health Benefits

Utilize benefits that provide for preventive coverage Semi-annual dental cleanings and exams Annual eye exam

Be a savvy consumer – can save you $$$ Choose plans that fit your situation best Familiarize yourself with spouse’s/partner’s plan Question doctor regarding procedures and necessity,

generic prescriptions, billing rates, joining carrier’s in-network listing, referrals to in-network specialists

Open Enrollment - BeneTrac

BeneTrac: We will notify you when you can access the system for enrollment.

BCBS MA / Delta Dental & VSP – If you are enrolled and you do not want to make any changes, you do not need to do anything but you should review your BeneTrac account and click “finalize”.

Group Life/AD&D and Disability - You are automatically enrolled for the group benefits.

Voluntary Life – If electing to increase your Voluntary Life, or enroll for the first time, please complete an application. If you are adding to existing coverage, or a new enrollment exceeding the Guarantee Issue amounts, you will also need to complete an Evidence of Insurability Form.

Flexible Spending Accounts for 2010 – If you are enrolling, you must re-elect your contributions in BeneTrac, even if you were enrolled last year.

Life Changes

Must be done within 31 days from Qualifying Event

Birth or adoption of a child or dependent change Marriage, divorce, or domestic partner Child(ren) – Full-time students between the ages of 19

and 25 Spouse’s change of employment Temporary assignment outside of coverage area