CBJ/Bartlett Employee Benefits May 2014
Overview • Aflac Group Voluntary Benefits • ICMA-RC Deferred Compensation Plan • Health Benefit Changes
City and Borough of Juneau • Group Accident Insurance • Group Critical Illness Insurance • Group Disability Insurance Continental American Insurance Company (CAIC ), a proud member of the Aflac family of insurers, is a wholly-owned subsidiary of Aflac Incorporated and underwrites group coverage. CAIC is not licensed to solicit business in New York, Guam, Puerto Rico, or the Virgin Islands. Continental American Insurance Company • 2801 Devine Street • Columbia, South Carolina 29205 3
What is Voluntary Insurance? • Voluntary insurance plans are not designed to replace insurance you already have. • Voluntary insurance enhances your existing benefits package. • Benefits can be used to help pay expenses that other insurance plans don’t cover. 4
Features of Aflac Plans • Fast Claims Payment—Most claims are processed in about four days. • Unlimited Claims—There is no limit on the number of claims a certificate holder can file. • Payroll Deduction—Premiums are paid by convenient payroll deduction. • Portable Accident and Critical Illness Coverage—Employees can continue through bank draft or direct billing as long as the master policy stays in force. 5
Products Offered • The following products will be offered during your enrollment: • Group Accident Insurance • Group Critical Illness Insurance • Group Disability Insurance 6
Accident Insurance Group Accident Insurance from Aflac helps pay for out-of-pocket costs that arise when you have a covered accident such as fractures, dislocations and lacerations. This coverage is non-occupational. During the initial enrollment, and for newly eligible employees, coverage is guaranteed-issue. More than 50 benefits are payable including the following: • Emergency treatment • Hospital admission • Intensive care unit • Ambulance transportation • Wellness testing 7
Critical Illness Insurance Group Critical Illness Insurancefrom Aflac provides cash benefits if you’re diagnosed with or treated for a covered critical illness, such as cancer, a heart attack, or a stroke. More importantly, the plan helps you focus on recuperation instead of the distraction and stress over the costs of medical and personal bills. + Payment of the partial benefit for carcinoma in situ will reduce by 25% the benefit for internal cancer. Payment of the partial benefit for coronary artery bypass surgery will reduce by 25% the benefit for a heart attack. 8
Critical Illness Insurance Coverage is Guaranteed Issue in the following benefit amounts with no participation requirement: • $40,000 for employees • $20,000 for spouse coverage • Additional Benefits for • Coma • Paralysis • Burns • Loss of Sight, Speech, or Hearing • Advanced Alzheimer’s Disease • Advanced Parkinson’s Disease • Benign Brain Tumor • Waiver of Premium • Health Screening 9
Disability Insurance Group Disability Insurancefrom Aflac helps pay a portion of your income so that you can focus on taking care of yourself instead of your bills. Benefits include: • Total Disability • Partial Disability • Waiver of Premium • During the initial enrollment, guaranteed-issue is a monthly benefit of up to $5,000 with no participation requirement on DI. • Non-occupational coverage is available with the following elimination • period and benefit duration: 10
ICMA-RC Deferred Compensation Plan
City and Borough of Juneau and Bartlett Regional Hospital 457 Deferred Compensation Plan – Introduction to ICMA-RC Services Peter HoerberRegional Director, ICMA-RC May 5th, 2014 AC: TBD This presentation is the property of ICMA-RC and may not reproduced or redistributed in any manner without permission.
Goal – Improve the Plan Proposals from several providers considered and ICMA-RC was selected • Founded in 1972 – by and for public employees • Independent, non-profit • Over 1 million public sector participant accounts* • Over $53 billion in assets* • Alaska – 46 plans, including partnership with Juneau for over 31 years* We serve only the public sector! * As of March 31, 2014
How the Change will Help • Reduced fees • Streamlined investment options • On-site meetings, consultations • Online tools and resources þ þ þ þ
Your Investment Options are Changing • Existing fund assets to transfer to new, similar funds • Any surrender charges will be paid on your behalf • Will receive more details soon via mail You will not be required to take any action
Why Participate? Pension and Social Security may go a long waybut unlikely to be enough Help keep pace with inflation Leave potential inheritance for beneficiaries Supplement income for health care, major purchases, travel
Don’t Wait to Begin or Keep Saving When You Start Saving Matters Account Balance at age 65 * For illustrative purposes only. Assumes $50 bi-weekly contributions and 6% average annual return.
Increase Your Contributions Over Time Account value 20 years later: $272,805 $83,325 $189,000 A$25 BI-WEEKLY BOOSTeach year leads to over in additional savings! * For illustrative purposes only. Assumes $10,000 account value and $50 bi-weekly contributions at age 40 and 6% average annual return.
2014 Contribution Limits +$17,500 during each of the three years prior to year you reach normal retirement age* $35,000 +$5,500 if age 50 or over as of year end $23,000 Normal limit $17,500 $5,000 Can’t save the max? Smaller savings can go a long way, too! *Based on extent to which maximum contributions not made in previous years. “Normal retirement age” as defined in plan rules. The two catch-up provisions cannot be combined in same plan year.
Your ICMA-RC Representatives Retirement Plans Specialist • Mitch Jones • (866) 328-4664 • MAJones@icmarc.org • Deferred Compensation Plan questions Certified Financial PlannerTM • James Reinke, Certified Financial PlannerTMprofessional • (866) 838-0481 • JReinke@icmarc.org • Will help with your overall finances
What’s Next • Review transition materials • Review your financial situation • Are you saving enough? • Should you change your investments? • Should you consolidate retirement accounts? Take this opportunity to review and start your plan for retirement!
Questions? THANK YOU
CBJ Health Benefit Changes Prior Authorization Pharmacy Point of Sale Dental Benefits Annual Enrollment
Prior Authorization Some services through Premera now require an authorization prior to receiving them. This allows you to: • Find out if you’re covered by your health benefits before you have your scheduled procedure • Save money & avoid extra costs • Get an estimate of your out-of-pocket costs before you go • Avoid inappropriate or unnecessary medical treatment
Prior Authorization-continued • Some services that require Prior Auth: • Planned admission into hospitals or skilled nursing facilities • Non-emergency ground or air ambulance transport • Transplant & donor services • Some planned outpatient services • Some injectable medications you get in a healthcare provider’s office • Prosthetics & orthotics other than foot orthotics or orthopedic shoes • Reconstructive surgery • Home medical equipment costing $500 or more **This list is not complete. A more complete list can be found at premera.com.
Prior Authorization—continued • What should you do? • You should always ask your healthcare provider about requesting a prior authorization before you schedule a planned service or procedure. • Your doctor has the most current medical information needed to request a prior authorization on your behalf. • In-network (contracted) providers should call Premera for prior authorization
Prior Authorization—continued • What happens if I don’t get Prior Authorization? • Currently there is no penalty assessed for not getting a PA for medical services, but you may be responsible for the full cost of the procedure • If you have a procedure done by a contracted in-network provider that did not get prior authorization, the provider is responsible for the cost of the procedure • If you have a procedure done by a non-contracted (out of network) provider and did not get prior authorization, you may be responsible for the full cost of the precedure
Prior Authorization Take Away • Whenever possible, use an in-network provider. You can find in-network providers at www.premera.com • Make your provider aware that Prior Authorization is required for some scheduled medical procedures. • In-network providers should not refuse to check for prior authorization for you
Pharmacy Point of Sale • Pharmacy Point of Sale is a review process Premera takes to make sure medications for certain conditions—such as migraines, diabetes, high blood pressure or asthma—meet certain requirements before your prescription is covered.
Pharmacy Point of Sale-cont. • When you go to the pharmacy to fill your prescription, the prescription is checked to see if it meets recommended guidelines • The system looks at prior claims to see if there has been a process of trial & failure on the generic forms of the drug • If there has been a trial & failure process, the Rx will be filled • If there has not been a trial & failure process on a generic form, the Rx will not be filled and the pharmacist or doctor will have to contact Premera
Pharmacy Point of Sale-cont. • Any current exceptions that are in place will remain in effect • Existing prescriptions for anti-depressants/hypnotics (sleep aids) will not go through the review process • New prescriptions for anti-depressants/hypnotics will have to go through the review process • If a member has already tried the generic version of specific medications, the prescription should process through
Pharmacy Point of Sale-cont. • CBJ & Bartlett members already do a good job of choosing generic medication over name brand • Generic fill rate of 80.1% • Generic substitution rate of 98.7% • Check to see if your medication requires review at: www.premera.com > Member Services > My Premera Plan > Pharmacy > Understanding Your Benefits > Drugs Requiring Approval
Premera Dental Benefits • Due to some changes in the Affordable Care Act, the CBJ/Bartlett Dental coverage will now be unbundled from the Medical/Vision Plan • There are no changes to the coverage • You will have to enroll in Dental Coverage separately from Medical/Vision • There is no additional cost to you
BRH Enrollment • Employee Benefit Enrollment will take place through the HR Employee Self-Service portal or in-person through HR • You can do this at work or from your home PC at: • http://www.bartletthospital.org/humanResources/employeeportal.html
Take Aways • Practice Prevention—the CBJ/Bartlett Health Plan covers preventive care visits at 100% when you go to an in-network provider. These visits are important because they can help catch something before it’s too late. • Choose an in-network provider—by choosing an in-network provider, you will have a lower out-of-pocket cost. This is because in-network providers agree to a lower negotiated fee for services. • Reduce unnecessary ER visits—the average cost of an ER visit to the CBJ/Bartlett health plan in 2012-2013 was $1568.00, while the average office visit was $99.00. If you are unsure if you need to go to the ER, take advantage of Premera’s FREE 24-hour NurseLine. The number is 800-841-8343. It is also located on the back of your Premera ID card. • Buy Generic when available—this keeps pharmacy costs down for you and your health plan Do your part in keeping our health plan “healthy”!