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2015 USG Open Enrollment

2015 USG Open Enrollment. November 3 – 14, 2014. Plan Changes. Plan Name changes OA POS plan => Comprehensive Care Plan HSA OA POS Plan => Consumer Choice HSA plan New Programs and Tools Integrated Health Model (BCBSGa plans)

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2015 USG Open Enrollment

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  1. 2015 USG Open Enrollment November 3 – 14, 2014

  2. Plan Changes • Plan Name changes • OA POS plan => Comprehensive Care Plan • HSA OA POS Plan => Consumer Choice HSA plan • New Programs and Tools • Integrated Health Model (BCBSGa plans) • Castlight Transparency tool (for Comprehensive Care and Consumer Choice HSA plans) • BCBSGa Comparison Tool • CVS Caremark/Health - pharmacy vendor BCBSGa plans

  3. 2015 Healthcare Plan Premiums • This year, the Board of Regents approved moving to a new pricing model for our healthcare plans. • Using this new pricing model, two of our plans would be considered underpriced [the Consumer Choice HSA Plan (formerly the HSA Open Access POS) and the BlueChoice HMO plan) and one plan would be considered overpriced [The Comprehensive Care Plan (formerly known as the Open Access POS)]. • For this reason, premiums for the Consumer Choice HSA and BlueChoiceHMO plans will be increasing and the premiums for the Comprehensive Care plan will be decreasing. University System of Georgia

  4. Plan Changes – Comprehensive Care Plan (formerly OA POS plan) Increase in-network deductible from $300 single/$900 family to $500 single/$1,500 family Increase out of network deductible from $500 single/$1,500 family to $1,500 single/$4,500 family Increase in-network out of pocket maximum from $1,000 single/$2,000 family to $1,250 single/$2,500 family Increase out of network out of pocket maximum from $3,000 single/$5,000 family to $3,750 single/$7,500 family Increase in-network specialist office visit co-pay from $20 to $30 Add In-network urgent care co-pay of $35 then plan pays 100% Add ABA Autism Therapy Coverage Increase pharmacy out-of-pocket maximum to $1,100/member; capped at $3,300/family

  5. Plan Changes – Consumer Choice HSA (formerly HSA OA POS Plan) Increase out of network deductible from $2,500 single/$5,000 family to $3,000 single/$6,000 family Increase in-network out of pocket maximum from $3,000 single/$6,000 family to $3,500 single/ $7,000/family Increase out of network out of pocket maximum from $6,000 single/$12,000 family to $7,000 single/$14,000 family Increase in-network employee co-insurance from 15% to 20% Increase out of network employee co-insurance from 30% to 40% Add ABA Autism Therapy coverage

  6. Plan Changes – BlueChoice HMO Plan Increase primary care office visit co-pay from $20 to $30 (services priced at $20 co-pay change to $30 co-pay) Increase specialist office visit co-pay from $25 to $50 (services priced at $25 co-pay change to $50 co-pay) Increase out-patient hospital services co-pay from $100 to $200 Increase in-patient hospital services co-pay from $250 to $500 Increase urgent care co-pay from $30 to $50 Increase in emergency room co-pay from $150 to $250 Add ABA Autism Therapy coverage Add $500 co-pay to in-patient behavioral health services Add $30 co-pay to out-patient behavioral health services Decrease out-of-pocket max to $5,500/single and $9,900/family

  7. Plan Changes – BlueChoice HMO Plan - Pharmacy Increase brand name prescription drug co-pay from $25 to $35 Add 20% co-insurance to non-preferred brand name prescription drug with a $45 minimum and $125 maximum cost share Add pharmacy out of pocket max of $1,100/member and $3,300/family

  8. HMO Zip Code Functionality Changes • The HMO plans are currently offered based on the institution zip code for active employees. • Beginning 1-1-2015, the BCBS and Kaiser HMO plans will be offered based on the employee’s home zip code. • This will reduce the chance of someone electing a plan with poor coverage in their area. • Retiree eligibility for HMO plans is already based on the home address. There will be no changefor retirees. University System of Georgia

  9. Better Choices for a Healthier You! University System of Georgia

  10. ID Cards • Network displayed on the card instead of plan name • Effective date removed • USG Benefits logo added

  11. Tobacco Surcharge - 2015 Increasing from $50 to $75 per month Will continue to apply to spouses and dependent children 18+ All employees must certify tobacco use status during Open Enrollment If an employee does not certify, their tobacco use status will default to tobacco user and $75 per month will be added to their healthcare premium

  12. Spouse Questions • Spouse Questions • Do you have a spouse? • Does your spouse have access to healthcare plan coverage through his/her employer? • Are you planning to cover your spouse under a USG healthcare plan in 2015? If you answer Yes or No, please share with us why you made that choice in the box below. You may enter up to 144 characters.

  13. Retiree Coverage USG plan will become secondary coverage for all Medicare eligible retirees effective 7/1/15 USG will assist Retirees not currently enrolled in Medicare (‘grandfathered’) to enroll in Medicare during January – March 2015 USG will pay late enrollment penalty for retirees who enroll during this period As of 7/1/15 – rates will be the same for all retirees since the plan will be secondary coverage only – no longer have ‘enrolled and not enrolled’ rates

  14. Adding Dependents for Retirees • Retirees will be offered a one-time opportunity to add dependents ages 19-25 to their medical coverage only during Open Enrollment. • This was put into place in 2011 to satisfy part of the Affordable Care Act. • Programming will remain in place for this Open Enrollment and will be communicated to retirees as a one-time option. Programming will be removed for next year. University System of Georgia

  15. Dental – Delta Dental If the dependent has already been dropped at age 19 for not being a student, active employees may add the dependent back during Open Enrollment. University System of Georgia No changes to plan benefits Premiums are increasing slightly FT student status is removed as eligibility requirement effective 1/1/15

  16. Vision – EyeMed University System of Georgia No Changes to Plan benefits or Premiums FT student status is removed as eligibility requirement effective 1/1/15 If the dependent has already been dropped at age 19 for not being a student, active employees may add the dependent back during Open Enrollment

  17. Short and Long Term Disability – MetLife • No Changes to premiums or benefit • NEW Leave Coordination Administration in 2015 • Employees will have two options: • Employee uses sick/vacation leave during elimination period and then receives 60% short or long term benefit after elimination period • Employee uses sick and/or vacation leave until leave is exhausted and then receives 60% short or long term disability benefit - Employees uses sick or vacation leave or receives disability payment but not both University System of Georgia

  18. FSA/HSA – US Bank HSA • 2015 Match - $375/$750 • 2015 limits - Employee only: $3,350 ($2,975 net of match); Family: $6,650 ($5,900 net of match) FSA • Same as last year; Must re-enroll each year • For employees moving from an FSA to an HSA: • Employees are not allowed to contribute to an HSA while they have an active FSA. • Employees Health Care FSA balance must be $0 on or before January 1, 2015 or neither the employee nor USG will be allowed to contribute to new HSA until April 1, 2015. University System of Georgia

  19. New for 2015 • LifeStyle Benefits • Packages include Emergency Roadside Assistance, Identity theft, Legal Care, Tax Help Line, Pet Care, and Fitness Club discounts • Discount programs – not insurance • USG Perks – discount shopping program – offers discounts on variety of items such as airline tickets, hotels, electronics, clothing, movie theatre tickets, restaurants, etc. • Available in November for Christmas shopping! University System of Georgia

  20. What employees need to do • Opt in for text messaging! • Attend a local Benefits Fair or Benefits Meetings (if available) • Review USG Open Enrollment materials • Use plan Comparison Tool available through BCBSGa (WebMD) • Certify tobacco status during Open Enrollment • Enroll or make changes during the Open Enrollment – November 3rd – 14th! • Pre-register for Castlight University System of Georgia

  21. Questions?

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