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Current State of Affairs • Health care costs continue to rise—current inflation is 9-11% • Wellness plan and QHDHP Plan are making a difference • Proactive vs. Reactive • Wellness makes a difference • Raises Awareness • Changes Behavior • Controls Chronic Conditions • Awards participants • Through payroll contributions and Vitality • Wellness and QHDHP Plan will continue to be a part of SLU’s program for 2013 STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
Saint Louis University 2013 Objectives • Maintain competitive medical/prescription drug benefits • Continue to offer the choice between two plans: Plus and QHDHP • Provide plans at an affordable cost to both employees and SLU • Maintain a 75% employer/ 25% employee split in contributions STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
2013 Medical Plan Options STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
2013 Pharmacy Plan Options Under the QHDHP, certain preventive, or “maintenance,” medications are covered at 100%... No copay or deductible! STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
2013 Cost Sharing • Slight payroll deduction decrease for wellness participants • Wellness Incentive increased from $30 to $50 for 2013 • $25 wellness incentive added for spouses STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
QHDHP and Dependent Audit Results QHDHP Plan: • Overall HSA Plan participation was better than expected • Increased consumerism for participants • Encourages informed health care decisions • With the Health Savings Account, members are able to use their pre-tax dollars to pay for medical and pharmacy expenses; • Any unused funds roll over to the next year and can be used as a savings vehicle for retiree medical expenses Dependent Eligibility Audit Results: • Audit completed to ensure medical plan only covers eligible individuals and to ensure the University meets their fiduciary responsibility • Total Employees Audited: 1,771 • Total Dependents Audited: 3,861 • Total Dependents Removed from the medical plan: 314 • Estimated Total Savings: $500,000 STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
Other Items of Discussion Eligibility Waiting Period: • Effective January 1, 2013, the current eligibility waiting period of “Date of Hire” will be changed to “First of the Month following Date of Hire” • Applies to new hires only • Matches more closely with other universities, including Jesuit schools Health Reform Impact: • Effective January 1, 2013, the definition of women’s preventive care services will be expanded • Applies to generic drugs only HSA Seed Money: • If you enroll in the Qualified High Deductible Health Plan for 2013, SLU will continue to contribute money to your account to help build your balance • $250 for Employee Only • $500 for Employees with Dependents STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
UHC’s Diabetes Programs Diabetes Programs: • UHC offering two programs that will be rolled out: • Diabetes Prevention and Control—effective October 1, 2012 • Identified pre-diabetics can work with YMCA lifestyle coaches to prevent the progression of diabetes • Diagnosed diabetics can work with Shop N’ Save pharmacists via face-to-face consultations to help improve their prescription compliance, set goals, and review lab work • Diabetes Health Plan—effective January 1, 2013 • Members are identified by onsite biometric screenings or health verification forms as diabetic or pre-diabetic • Identified members can be incentivized to comply with recommended Medical and Rx guidelines STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
Express Scripts Programs • SLU will be implementing several initiatives to help manage the prescription program: • Fraud, Waste, and Abuse Program • Identifies unusual or excessive utilization patterns • Medication Adherence Program • ESI will reach out to members through home mailings whose adherence is below 80% • Additional Prior Authorizations on Specialty Drugs • Additional Drug Quantity Management Limitations STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
Delta Dental • The 2013 rates will not be changing! • Coverage is voluntary and 100% employee paid via pre-taxed payroll deductions like the medical plans • Through Delta Dental, SLU offers three plans to choose from: • Flex – Most comprehensive benefits and networks • Basic Plus – PPO only network, slightly less benefit than the Flex Plan • Basic – PPO only network with no major or orthodontia • Delta has one of the largest PPO networks in the country • Delta’s Premier network in the Flex plan provides additional network coverage that would otherwise be out of network with other carriers • Don’t forget your FSA or HSA dollars can be used for dental expenses STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
Long Term Care • As of 12/31/2011, John Hancock officially exited the long term care marketplace for new applicants • SLU has identified Genworth as the replacement carrier • Participants can keep their current policies with John Hancock and/or move their policy to Genworth • Mailings sent to employees’ home addresses August 29 • Open Enrollment: September 5 to September 28 • Meetings will be held on campus on September 11 - 14 • More information at hr.slu.edu STLUN08\Presentations\2012\Employee Open Forum 8-13-2012.pptx
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