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Shattuck - St. Mary’s School Open Enrollment 2012 - 2013

Shattuck - St. Mary’s School Open Enrollment 2012 - 2013. Medical Benefits by HealthPartners – No Changes !!!. Choice of 2 plans Open Access $500 - $25 Open Access $1700-75% HRA National Network CIGNA

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Shattuck - St. Mary’s School Open Enrollment 2012 - 2013

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  1. Shattuck - St. Mary’s SchoolOpen Enrollment2012 - 2013

  2. Medical Benefits by HealthPartners – No Changes!!! • Choice of 2 plans • Open Access $500 - $25 • Open Access $1700-75% HRA • National Network • CIGNA Reminder: Deductibles and Out-of-Pocket Maximums accumulate on the Plan Year (July through June) for the HRA plan and the calendar year (January through December for the copay plan

  3. Plan Highlights Comparison

  4. Plan Highlights Comparison

  5. HDHP Plan – 1700HRA Max. Out-of-Pocket: Single: $3,500 Family: $7,000 With HRA Contribution ‘True” OOP: Single: $2,750 Family: $5,500 The HRA is treated as member money as payments count towards both medical plan deductible and out-of-pocket maximum. 100% In Network Coverage 75% In Network Coverage to Max. Out-of-Pocket Deductible $1,700 single/$3,400 family (Plan Year Deductible and OOP) The HRA automatically pays for deductible claims. Member Responsibility Single $950 Family $1900 Prescription Drug Co-pays $12/$50/$75 100% Preventive Care Coverage 100% of unused HRA amounts carry forward year-to-year. HRA is Employer Funded HRA Single $750 HRA Family $1500 HRA Family $1,500 Rx claims are subject to co-pays with HRA plans. Reimbursed by HRA Account.

  6. Health Reimbursement Arrangement (HRA) • Shattuck – St. Mary’s funds the HRA Account at $750 (single) and $1,500 (family) • Upon depletion of the HRA Account, employee pays expenses incurred until deductible level and out-of-pocket maximums have been reached • 100% of unused HRA Account dollars will roll into next plan year • HRA Account Maximum • Single: $1,500 • Family: $3,000

  7. Provider claim Member $ $ $ $ Health Plan $ $ $ $ $ $ claim Account CDHC: How it Works… Step 1: Member seeks medical care. Step 2: After care is received; provider sends claim to HealthPartners. Step 3: HealthPartners processes the claim and sends the Explanation of Benefits to member and to the HRA account. *If there are funds available in the HRA account, a check will either be sent to the member or directly deposited into their checking / savings account. If there are no HRA funds available, the member can choose to remit the EOB to their FSA account. Step 5: The Provider bills member for services. Step 6: The member is responsible for paying the provider. *Prescription drug co pays are automatically rolled to the HRA account. Member Health Plan

  8. 2012-2013 Employee Contributions • $1700 HRA MonthlyAnnualSavings: HRA vs. Copay • Single $0.00 $ 0.00 • Single + Spouse $300.80 $ 3,609.7 0 $ 730.82 • Single + Child(ren) $248.13 $ 2,977.56 $ 657.00 • Family $505.59 $ 6,067.08 $ 1,020.84 • $500-$25 • Single $0.00 $ 0.00 • Single + Spouse $361.71 $ 4,340.52 • Single + Child(ren) $302.88 $ 3,634.56 • Family $590.66 $ 7,087.92

  9. Real Life Examples – Single Coverage

  10. Real Life Examples – Family Coverage

  11. Which Option To Choose? • Things to Consider • Review previous claims history • Estimate (to the best of your ability) future claims • “Maximum” Exposure • Premium • Annual “True” Out-of-Pocket Maximum:

  12. Additional HealthPartners Benefit – “VIRTUWELL”Their Online “House Call” First THREE visits FREE!!! (per member per year) www.virtuwell.com • Available 24/7 • Simple conditions • Sinus or ear pain • Pink eye • Bladder infections • Log on and complete 10-minute interview • Nurse Practitioners • Review information • Respond with diagnosis/treatment plan (about 30 minutes) • Can prescribe medications to your selected pharmacy • Copay Plan - $10 copay • HRA Plan - $40 charge subject to deductible and coinsurance

  13. Resources… Help is just a phone call away • Member Services • 7:30 a.m. – 7:00 p.m. (CST) weekdays by phone, plus face-to-face visits available • CareLine • 24/7 nurse phone line staffed with Registered Nurses • Nurse Navigators • Answers to complex medical and benefit questions • BabyLine • For new moms and moms-to-be (dads, too!) staffed with specially trained OB/GYN Nurses

  14. Resources…www.healthpartners.com • Personal Claims / Benefit Information • Register a personal user name/password for access • All Members must have own user name/password • Consumer Tools / Cost Calculator • Annual medical cost planner • Treatment and procedure costs • Drug cost calculator • Formulary • Search by drug name or category

  15. What can I do on my phone? Search for urgent care, clinics or hospitals near you See your Member ID card Call the 24/7 CareLineSM nurse service Go to m.healthpartners.com from your smart phone

  16. AchieveSM Programs • Frequent Fitness Program • Join up and work out 12 days per month at any of the participating health clubs and earn a $20 credit on your monthly club dues • Two adult members qualify for credit • For a current list of clubs, visit healthpartners.comor call Member Services at 952-883-5000 • Healthy Discounts • Weight Watchers, Nutrisystem, Foss Swim School, 2nd Wind Exercise, Jazzercise, Yoga North, Good Life Yoga

  17. NEW!!! Dental Benefits – HealthPartners Dental • In-Network Highlights • $1,000 Calendar Year maximum per covered member • 100% preventive coverage • $50/$150 Deductible • 80% basic care coverage (deductible applies) • 50% major restorative coverage (deductible applies) • Out-of-Network • $750 Calendar Year maximum per covered member • 80% preventive coverage • $50/$150 Deductible • 60% basic care coverage (deductible applies) • 50% major restorative coverage (deductible applies) • Balance billing may apply 1/1 – 6/30 Data from MetLife will be provided to HP

  18. Employee Dental MONTHLY Contributions Monthly Single $ 0.00 Employee + One $ 29.03 Family $ 72.40

  19. Life and LTD – NEW!!! • Lincoln Financial Group • No changes to benefits • Basic Life / AD&D • One times annual salary to $50,000 • If enrolled at initial eligibility • Dependent Spouse $5,000 • Dependent Child $1,000 • LTD • 60% to $5,000/month • 90 day elimination

  20. Voluntary Life • One-time open enrollment • Guarantee issue with no medical evidence • Employee $10,000 increments to $130,000 • Spouse $5,000 increments to $30,000 (50% of EE) • Child(ren) up to $10,000 • Employee must have coverage for dependent coverage

  21. Voluntary Life Rates

  22. Value-Add with Lincoln - TravelConnect • Travel Assistance Services • MEDEX Assistance Corporation • Available to all employees enrolled with Basic Life • Traveling 100+ miles from home • Medical evacuation and transportation • Security and political evacuation • Lost/Stolen travel documents • Language translation • Emergency travel arrangements MEDEX ID: 322541 Group Name: Lincoln Financial Group

  23. Employee Assistance Program (EAP) The number to call when you don’t know who to call! • HealthPartners EAP • Available to all employees • Confidential • 24 hours a day – 7 days a week • Telephonic Only 1-866-326-7194 • Lincoln with EmployeeConnect EAP • Available to employees with LTD coverage • Confidential • 24 hours a day – 7 days a week • 1-877-757-7587 • 4 Face-to-Face visits per issue per year www.eapadvantage.com Password: connect

  24. Open Enrollment – What do you need to do? • Medical Enrollment/Change Form • Dental Enrollment • MUST complete enrollment form • Voluntary Enrollment Form • Life Beneficiaries All forms to Michelle Mahowald in Human Resources no later than June 13, 2012 JUNE 13

  25. QUESTIONS?

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