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Choosing Your Medical Plan

Choosing Your Medical Plan. Columbia Public Schools. BASIC PLAN. PLUS PLAN. Part 1. Medical Plan: Basic vs. plus. Columbia Public Schools. Medical Plan Options. Basic Plan. Plus Plan with Health Savings Account. Columbia Public Schools. Changes for 2013.

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Choosing Your Medical Plan

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  1. Choosing Your Medical Plan Columbia Public Schools BASIC PLAN PLUS PLAN

  2. Part 1 Medical Plan:Basic vs. plus Columbia Public Schools

  3. Medical Plan Options • Basic Plan • Plus Planwith Health Savings Account Columbia Public Schools

  4. Changes for 2013 *Prorated amounts for the part-time employee Columbia Public Schools

  5. What You Need to Do Open Enrollment election forms are duein Business Services on November 30, 2012 Columbia Public Schools

  6. What is the Basic Plan? • $500 deductible (individual) • $1,500 maximum out-of-pocket limit (individual) • $15, $30, and $45 prescription drug copays • Mail order copays: $25, $55, and $90 for90-day supply The Basic Plan is our traditional health plan, with: Columbia Public Schools

  7. What is the Plus Plan? • $1,400 deductible (individual)/$2,800 deductible (family) • Prescription costs and other eligible expenses count toward the deductible • 100% coverage after deductible is met, for in-network services • Maximum out-of-pocket for individual coverage is $1,400; family maximum is $2,800, for in-network services • If eligible, employee opens a Health Savings Account • District contributes $600 annually to the employee’s Health Savings Account, lowering the total out-of-pocket maximum to $800 per year • Employee makes pre-tax contributions to the Health Savings Account • Use the Health Savings Account to pay for qualified medical expenses Columbia Public Schools

  8. What is the Plus Plan? • A qualified high deductible health plan (QHDHP) that satisfies Internal Revenue Service requirements regarding deductibles, contributions, and out-of-pocket expenses • The deductible on thePlus Plan meets theIRS guidelines forQHDHPs QHDHP Columbia Public Schools

  9. What is a Health Savings Account? • A Health Savings Account is a tax-free opportunity to save and pay for your qualified out-of-pocket health expenses • A Health Savings Accountis associated only with aQualified High DeductibleHealth Plan (our Plus Plan) • A Health Savings Accountis similar to, but differentfrom, a Flexible SpendingAccount QHDHP Columbia Public Schools

  10. Comparison of Basic and Plus PlansEffective January 1, 2013 Columbia Public Schools

  11. Deductible Notes Plus PlanFamily Deductible Note Basic PlanFamily Deductible Note  The Plus Plan family deductible is $2,800 per year. This means that if you have more than one person on the Plus Plan, you will need to reach the $2,800 deductible before ANY eligible expense will be covered by insurance. Once the deductible is met, insurance pays 100% of eligible expenses.  The Basic Plan family deductible is $1,000 per year. The $1,000 can be a combined deductible of all of the covered family members. Remember that if one individual in the family meets the $500 deductible, insurance will begin to pay on that one individual.   Columbia Public Schools

  12. Health Savings Account Enrollment Eligibility To be eligible to contribute to a Health Savings Account, you must: • Be covered by the Plus Plan • Not be covered by another health plan that is not a high deductible health plan • Not be covered by Medicare • Not be covered by a spouse’s plan that hasa deductible of less than $1,200 for a single plan,or $2,400 for a family plan • Not be covered by another plan that coversfirst dollar expenses, like prescription copaysor office visit copays • Not be covered as a dependent on another’stax plan Columbia Public Schools

  13. Health Savings Account Enrollment Eligibility The IRS does not allow you to “double-dip” on saving taxes on medical expenses! This means: • If you are married and your spouse has a traditional flexible benefits plan, you would not be eligible to contribute to a Health Savings Account Columbia Public Schools

  14. Enrollment Eligibility • Plus Plan • Health Savings Account Anyone can enroll Must be eligibleto contribute Columbia Public Schools

  15. Health Savings AccountDistrict Contribution • Amount of district contribution will be determined each year; cost is the difference between the Basic Plan premium and the Plus Plan premium • If you are eligible for a Health Savings Account, the district will contribute $600 to the Health Savings Account over the course of the year for the full-time employee • Example: $50 x 12 = $600 Columbia Public Schools

  16. Health Savings AccountDistrict Contribution } $50 x 12 = $600 $400 deposited to Health Savings Account on January 31, 2013 $50 deposited to HSA $50 deposited to HSA $50 deposited to HSA $50 deposited to HSA $200 on September 30, 2013 Columbia Public Schools

  17. Health Savings Account Benefits You can: • Contribute pre-tax money to your Health Savings Account through payroll deduction, based on your health care needs; use the money in the Health Savings Account to pay for your health care expenses • Maximum contribution: • Single coverage: $3,250 per year (max includes district’s amount) • Family coverage: $6,450 per year (max includes district’s amount) • Contribute an extra $1,000 into the Health Savings Account if you are over 55 • Contribute by making deposits in person at Landmark Bank • Elect in November how much you want deducted from your paycheck • Cannot change payroll deduction amount in 2013 Columbia Public Schools

  18. Whose expenses can you pay for with your Health Savings Account? • Dependents’ expenses count if you claim them on your income tax return—even if dependents aren’t on CPS insurance plans • Health Savings Account qualified expenses include: • Over-the-counter drugs must be prescribed by a doctor • Glasses, contact lenses, eyeexams • Dental expenses • Deductible (remember, you pay100% of expenses up to first$1,400, including prescriptioncosts—less $600 annual districtcontribution) Reminder Columbia Public Schools

  19. What other expenses arereimbursable from yourHealth Savings Account? • Services not covered by the medical plan that do not count toward the deductible, such as: • Well visits • Sports physical costs • Hearing aids • Lasik eye surgery Columbia Public Schools

  20. Things to Remember AboutHealth Savings Accounts • The district’s contribution helps offset your deductible and out-of-pocket maximum • Payroll contributions (and other contributions) are tax-free • The money in your Health Savings Account is always your money • If you leave employment or retire, the Health Savings Account is still yours—it is portable • Earnings in your account grow tax-free • If you use this money for non-qualified expenses, you will be taxed on the amounts spent plus 20% penalty • You can use the Health Savings Account for medical expenses after employment ends, as the money is always yours • After age 65, you can pay CPS retiree premiums with your Health Savings Account • The balance in your account rolls from year to year • You will have to plan on how you will pay for expenses during the first part of the year when your Health Savings Account balance hasn’t had time to accumulate Columbia Public Schools

  21. How to Get Money Out of Your Health Savings Account • Pay the doctor/provider directly from your Health Savings Account debit card or check OR • Pay the doctor/provider directly with yourown cash, check, or credit card, then later write a check to yourself from your HealthSavings Account for expenses • Keep documentation of theexpenses for your records,in the event of an audit It’s simple: Columbia Public Schools

  22. Tax ReportingRecordkeeping Requirements • W-2 will show your payrollcontributions • Bank issues Form 5498 each year in May, which reports employer and employee contributions • Form 8889 is completed with yourincome tax return to determine anyexcess contributions or taxabledistributions. Form 8889 is simple: • Report your contributions • Report your expenses (keep yourdocumentation of expenses) • Report any taxable distributions It’s simple: Columbia Public Schools

  23. Example: Minimal User * $75 toward deductible plus$30 Rx copay = $105 ** $285 toward deductible Columbia Public Schools

  24. Example: Average User * $450 toward deductible plus$150 Rx copay = $600 ** $1,078 toward deductible * $450 toward deductible plus$160 Rx copay = $610 ** $1,294 toward deductible Columbia Public Schools

  25. Example: Above Average User * Out-of-pocket maximum ** $1,400 toward deductible *** $1,500 out-of-pocket max plus $2,600 Rx copays = $4,100 Columbia Public Schools

  26. The Big Picture How much can you save over the yearsby having a Health Savings Account? • Employer ($600 for 2013) • Employee • Payroll deduction • In-person deposits at bank Health Savings Account Account balance rolls over year to year

  27. Plan CostsEffective January 1, 2013 * District-paid Columbia Public Schools

  28. How to Choose • Think about your health care expenses; are you a minimum user, average user, or above average user? • Don’t forget to count in the district’s Health Savings Account contribution • If you have family coverage, remember to count premium savings as you weigh your choice • Consider these factors: • Deductibles • Out-of-pocket maximums • Prescription costs • Plan how you would pay for unexpected expenses early in the year with the high deductible (Plus Plan) Columbia Public Schools

  29. Part 2 Flex Plan:Traditional vs. Limited Columbia Public Schools

  30. Basic Medical Plan • Plus Medical Plan with Health Savings Account Flex Plan Options • TraditionalFlex Plan • LimitedFlex Plan Columbia Public Schools

  31. Flex Plan Qualified Expenses with HSA Basic Plan Plus Plan Traditional Flex Plan Limited Flex Plan Dental expenses Glasses, eye exams, contacts Orthodontic expenses • Deductibles • Prescription copays • Glasses, eye exams, contacts • Lasik eye surgery • Dental expenses • Hearing aids • Orthodontic expenses • Over-the-counter drugs (must be prescribed by a doctor) • Other services not covered by the medical plan NO MEDICAL $2,500 maximum allowed $2,500 maximum allowed Columbia Public Schools

  32. You can have: • Pre-tax payroll deductionsto Health Savings Accountplus district’s contribution toHealth Savings Account • HSA Qualified Expenses • PrescriptionsDeductiblesOver-the-counter drugs (if prescribed by a doctor)Hearing aidsLasik eye surgeryGlassesVision examsContacts • Dental Enroll in the Plus Plan and Pay Your Out-of-pocket Expenses Like This Health Savings Account Limited Flex • You can have: • Pre-tax payroll deductions to limited flex • Limited Flex Qualified Expenses • NO MEDICAL • GlassesVision examsContacts • Dental AND Contribution maximum: Single: $3,250 (includes district contribution) Family: $6,450 (includes district contribution) Contribution maximum: $2,500 Reimbursable under Health Savings Account or Limited Flex

  33. HSA and Flex Plan Qualified Expenses • The HSA and Flex Plan share the same list of eligible and ineligible expenses • In your open enrollment packet, see the Frequently Asked Questions about HSAs • On the back of the Frequently Asked Questions page is a listof eligible and ineligible expenses for the HSA • The same list applies to both plans Columbia Public Schools

  34. Open Enrollment • Employees can add a dependent to the medical plan of their choice • Coverage begins January 1 • Form to add a dependent to the plan must be received by Business Services by November 30 Columbia Public Schools

  35. Open Enrollment • You will be allowed to choose between the plans each year during open enrollment • If you enroll in the Plus Plan for 2013, accumulate a balance in your Health Savings Account, and decide at a subsequent open enrollment that you wish to switch to the Basic Plan, you may do so; once the money is in your Health Savings Account, it belongs to you • However, as long as you are enrolled in the Basic Plan, you will not receive any new Health Savings Account contributions from the district, and you may not put additional money into the Health Savings Account yourself Columbia Public Schools

  36. Open Enrollment Thanksgiving Columbia Public Schools

  37. Medical Plan Enrollment Choices Basic Plan • No action is necessary for employees wanting the Basic Plan, which is similar to the current plan only with a higher deductible and increased prescription copays • Can add a dependent to medical plan in November BASIC PLAN Columbia Public Schools

  38. Medical Plan Enrollment Choices Plus Plan Employee completes enrollment form and submits by November 30 Can add a dependent to medical plan at this time Employee completes payroll deduction form for Health Savings Account contribution If employee is a new participant, employee opens account with Landmark Bank Name the beneficiary for your account Choose checkbook or debit card or both No monthly fee Earnings grow tax-free PLUS PLAN Columbia Public Schools

  39. Other Enrollment Options • Traditional Flex Plan • For those enrolled in the Basic Plan • Election form required for 2013 election • Limited Flex Plan • For those enrolled in the Plus Plan • Election form required for 2013 election • Dependent Care Reimbursement • Flexing your day care • Election form required for 2013 election Columbia Public Schools

  40. Additional Information on the Employee Benefits Web Site http://www.columbia.k12.mo.us/bcs/bcsbus/EmplBen.htm • Plan comparison—How to choose • Decision calculator • Prescription drug information—Medtrak Pharmacy Web site • FAQ on HSAs • Landmark Bank brochure for HSA Kelly Rich Benefits Assistant Columbia Public Schools 1818 W. Worley Columbia, MO 65203 (573) 214-3710 krich@columbia.k12.mo.us Jane Harmon Benefits Manager Columbia Public Schools 1818 W. Worley Columbia, MO 65203 (573) 214-3710 jharmon@columbia.k12.mo.us Columbia Public Schools

  41. Your Homework • Go to the Employee Benefits Web site and click on Plan Comparison Calculator for assistance in making your choice. • You will need information about your prescription usage for the calculator. An easy way to get your prescription history is to go to the MedTrak Pharmacy Web site. • If you haven’t already done so, please register at MedTrak’s online services, to view your prescription history costs. This valuable tool can help you make your enrollment choice. For prescription drug information, go to www.medtrakservices.com and click on the Members tab at the top. Go to Need to Register?. For the Cardholder ID entry, enter the number from your medical ID card. Next, log in by creating a user ID and password. You will have access to a history of your prescription drug purchases, your costs, and total cost of your prescriptions. The MedTrak information will help you carefully analyze your prescription drug use and cost. To get the total cost of the drug, add your copays and the plan costs together. • NOTE: If you don’t have computer access, contact your pharmacy and ask for a statement of your account for the past year. Be sure to ask for the history of the copay amounts you paid aid the true cost of the drug. This will help you carefully analyze your prescription use and cost. Columbia Public Schools

  42. Choosing Your Medical Plan Columbia Public Schools BASIC PLAN PLUS PLAN

  43. Comparison of Basic and Plus Plan 2013 Columbia Public Schools

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