Presentation Transcript

1. Benefits Open EnrollmentNov. 1 – Dec. 2, 2013DEBCP Training
2. Presentation Overview UPlan Benefit Changes for 2014 Medical & Pharmacy Wellness Life Insurance Open Enrollment Basics Open Enrollment Assistance Common Questions
3. UPlan Benefit Changes for 2014
4. UPlan changes due to Affordable Care Act (ACA) 2011: Adult child coverage to age 26 - $2M cost for UPlan 2013: Healthcare Flexible Spending Account limited to $2,500 Additional preventive benefits New appeal processes Value of your 2012 tax-exempt medical insurance shows on W-2
5. 2014 UPlan changes also due to Affordable Care Act (ACA) 2014 UPlan changes are needed due to an ACA excise tax that begins in 2018 Tax applies to high value plans such as the UPlan If no changes, we would have a UPlan excise tax liability of $48 million University needs to avoid the excise tax Changes need to be made in 2014 to assure we are ready to avoid excise tax in 2018
6. 2014 Medical Plan changes Out-of-Pocket costs will be increased New deductibles on all non-copay items $100/$200 on Medica Elect/Essential $200/$400 on Medica Insights and Choice Primary care and related copays will increase by $10 Family medicine, internal medicine, OB/GYN, pediatrics Also chiropractic, acupuncture, PT, OT, ST & MH/SA New higher copays for specialty care $10 higher than primary care (+ $10 in ACO plan)
7. 2014 Medical Plan changes Higher out-of-pocket expenses in Health Savings Account Plan $250 / $500 reduction in HSA account $500 / $1,000 increase in out-of-pocket maximum
8. 2014 Medical Plan Changes – Twin Cities A new ACO (Accountable Care Organization) Plan High-quality; cost effective; care provided by a single group of hospitals, doctors, and other medical providers Benefits slightly higher than Base Plan Costs slightly lower – a “buy down” plan Four Twin Cities ACOs within this plan Fairview & North Memorial Vantage Plan (with UMP & Boynton) Inspiration Health by HealthEast Park Nicollet First (does not include HealthPartners) Ridgeview Connect
9. 2014 Medical Plan Changes – Twin Cities ACO Plan continued Annual Elections - Employee & all family members will select same ACO for the full year Members can see any primary care or specialty provider within ACO network. Referrals outside the ACO are unlikely! Travel benefit covers care outside service area Emergency, urgent & non-emergency care Care within service area, but outside of ACO, is out of network ACO providers will reach out to new members
10. 2014 Pharmacy Program Changes Tier 3 – Non-formulary brand copay increased to $75 Encourages use of Tier 1 and Tier 2 clinically appropriate, cost effective medications Current Prior Authorization and appeal provisions remain in effect The annual Rx Out-of-Pocket Maximum remains the same: $750 per person, $1,500 per family (Does not apply to HSA Plan)
11. Administrative Changes
12. Administrative Changes Spouse/SSDP and Family tiers will be combined over two years Employee + Family costs go down slightly Employee + Spouse/SSDP costs increase
13. Medical Plan Costs
14. 2014 UPlan Medical Contributions UPlan Standard Medical Plan contributions are: Employee only coverage University pays 87% - Employees pay 13% Family coverage University pays 80.5% - Employees pay 19.5% UPlan Wellness Achievement Rates are reduced by: $300 for employee and employee plus children rates $400 for employee plus spouse/SSDP and employee plus spouse/SSDP and child/children See the Guide for UPlan Benefits Enrollmentfor plan options and rates
15. Help for Lower Paid Employees to Pay Medical Costs 2014 Medical Cost Relief Program for lower income employees Credit based on plan selected and household income Credits range from $200-$500 Credit appears in 2014 paychecks, beginning January 22, 2014 Final Deadline for Applications: December 17, 2013 New applications are required – even if you participated in the past See Employee Benefits website at www.umn.edu/ohr/benefits for an application and program guidelines
16. 2014 Wellness Program Changes
17. Wellness Assessment The Wellness Assessment will be available for a longer time period UPlan members will now be able to take the assessment between: October 01, 2013 – March 31, 2014
18. Fit Choices New points level: earn 125 wellness points for 12 visits per month for six months Current point level: continue to earn 75 points for 8 visits per month for six months Fit Choices runs from October 1, 2013, to July 31, 2014 Both points levels are eligible for $20 reimbursement
19. Medication Therapy Management Face-to-face consultations with an MTM Pharmacist for UPlan members taking four or more covered prescriptions. Wellness Points: 100 Minimum visits: Three Provider: MTM Pharmacy Network
20. Specialty Therapy Management For members using specialty medications for the following disease states: Multiple Sclerosis, Rheumatoid Arthritis, Hepatitis C, Psoriasis, Psoriatic Arthritis, Crohn’s Disease, and Cystic Fibrosis. Telephone consultations with specialty pharmacy nurse Minimum calls: Three Earn 100 Wellness Points Provider: Fairview Specialty Pharmacy
21. New Reimbursement Programs Heart Rate Express – through Twin Cities Rec Center Mindfulness in Motion (MiM) – through Center for Spirituality & Healing Virtual Mindfulness Based Stress Reduction – for coordinate campus employees – through Center for Spirituality & Healing You pay up front; then get reimbursed upon completion of program
22. 2014Life Insurance Changes
23. Two Types of Changes Changes to simplify human resources processes and improve efficiency Changes due to recent Life Insurance Request for Proposal (RFP)
24. Life Insurance changes: simplify human resources processes & improve efficiency Full-time employee Basic Life benefit increased from 100% to 115% Part-time Basic Life benefit changed from full-time to part-time equivalent Basic Life maximum benefit capped at $200,000 Rounding feature changed from next higher $5,000 to next higher $1,000 $5,000–$25,000 additional Basic Life benefit for faculty and P&A eliminated One-month U of M death benefit eliminated
25. Life Insurance changes: simplify human resources processes & improve efficiency Most employees will benefit from the 2014 Life Insurance benefit changes
26. Life Insurance changes: simplify human resources processes & improve efficiency Those who do not benefit can transfer Basic Life coverage difference to Additional Life coverage without the need to provide proof of good health Example: Employee has $75,000 of Basic Life coverage in 2013 and $58,000 of Basic Life coverage in 2014 Employee can transfer $17,000 of Basic Life coverage to Additional Life for 2014 Additional Life rates are age-rated
27. Life Changes due to Request for Proposal $10,000 Newborn Child benefit for firstchild Applies prior to enrolling, up to 60 days Child Life added to annual open enrollment – without proof of good health New term life portability benefit (in addition to whole life Conversion policy)
28. Open Enrollment Basics
29. When and How to Enroll Open enrollment dates: November 1 – December 2, 2013 You can make changes to your benefits selections online at http://hrss.umn.edu If you (or a dependent) are age 45 or older, you are required to provide your Social Security Number
30. During Open Enrollment,You Can Add or cancel Medical or Dental coverage Select a different Medical or Dental plan Change your designated dependents Verification of dependent eligibility will be requested following Open Enrollment Choose to participate in the Health Care or Dependent Daycare Flexible Spending Accounts Enroll in Child Life
31. During Open Enrollment,You Can: Increase your amount of Short-term Disability coverage up to $200 per month, if you are a current participant Select or change the benefit amount of your voluntary Long-term Disability Coverage (Civil Service and Labor Represented employees only)
32. Don’t need to go online unless you want to: Set up a Flexible Spending Account for 2014 Change your Medical or Dental Plan or dependent coverage To change your clinic election only, just call Medica: 952-992-1814 or 1-877-252-5558 Add or increase your Long-term Disability coverage Add Child Life Note: to increase your Short-term Disability coverage, you will need to complete a paper application
33. Open Enrollment Assistance
34. Open Enrollment Assistance Phone: 612-624-8647 or 1-800-756-2363 Email: benefits@umn.edu Employee Health & Benefits Fairs Computer Lab (Twin Cities): Room 315 Donhowe Bldg. Nov. 25, 26, 27, and Dec. 2 (8 a.m. – 4:30 p.m.)
35. Employee Health & Benefits Fairs Duluth: October 31 Ballroom, Kirby Student Center 10 a.m. to 2:30 p.m. Crookston: November 7 Bede Ballroom, Sargeant Student Center, 12 p.m. to 2 p.m. Morris: November 11 Oyate Hall, UMM Student Center, 11 a.m. to 1 p.m. St. Paul: November 12 North Star Ballroom, Student Center, 10 a.m. to 3:30 p.m. Minneapolis: November 13 Great Hall, Coffman Memorial Union, 10 a.m. to 3:30 p.m.
36. Enroll Now Open Enrollment: November 1 to December 2, 2013 Enroll at http://hrss.umn.edu See the Guide for UPlan Benefits Enrollmentfor more information Coverage changes made during Open Enrollment are effective on January 1, 2014
37. Open Enrollment Procedures and Deadlines
38. New Hire Enrollment Procedures Employees hired and in PeopleSoft by October 29, 2013: Will receive Open Enrollment email announcement Can participate in Open Enrollment online Can view Guide for UPlan Benefits Enrollment online at www.umn.edu/ohr/benefits/openenroll
39. Newly Hired EmployeesEnrollment Procedures Recently hired employees may need to make two elections: For remainder of 2013 plan year For Open Enrollment changes, if desired Need two elections to participate in FSA for 2013 & 2014 Can make two elections online, but not at the same time: wait a day or two between enrollments Benefits will send email to these employees Employees hired on Dec. 1, 2013, or later, can make one election for 2014
40. Termination Dates Employees with termination dates prior to January 1, 2014, are not eligible for Open Enrollment If employee’s appointment date changes to extend past January 1, 2014, please refer the employee to the online Open Enrollment information Employee may encounter problems enrolling online right after appointment changes are made
41. Open Enrollment Communications Guide for UPlan Benefits Enrollmentwill be sent to all employees on Leave of Absence and to those in job codes who may not have regular computer access One set of medical & dental directories sent to each department Request additional sets for other locations Twin Cities UPlan members will receive postcard for Employee Health & Benefits Fair that can be used as entry for prize drawings
42. Open Enrollment Communications Email announcing Open Enrollment will be sent on November 1 to all benefits-eligible employees Email reminding employees that December 2 deadline is approaching will be sent about November 21
43. Benefits Materials for 2014 2014 Guide for UPlan Benefits Enrollment will be available by end of October for new employees 2014 COBRA instructions and rates will be updated and online by end of November 2014 Benefits Summaries for prospective employees will be updated and online by end of November 2014 Summary of Benefits for Medical and Dental Plans will be updated and online before end of December Check the Manager’s Toolkit on OHR website: http://www1.umn.edu/ohr/debcp/index.html
44. DEBCP Responsibilities for COBRA 2014 COBRA Instructions and Rates will be emailed at end of November and will be available online 2013 COBRA Rates will stay on the website until end of year You must send COBRA notice and application to terminated employees by U.S. Mail within 10 days of the employment termination date Complete verification form and send, scan, or fax to Employee Benefits
45. DEBCPs: Keep in Touch Help to keep the DEBCP email list current: if you are leaving or changing jobs, and you know who will be taking over as the DEBCP, please contact Employee Benefits Send updates to benefits@umn.edu
46. Thank you for attending and for your assistance!
47. Common Questions with Answers
48. Will I receive a paper copy of the benefits guide? Guide for UPlan Benefits Enrollmentwill be posted online at www.umn.edu/ohr/benefits/openenroll Employees without regular access to a computer and those on LOA will receive a paper copy of the guide All employees will receive a paper copy of the U & Your Benefits newsletter with enrollment details, including medical and dental plan rates, in your campus mailbox
49. Who can I cover on my UPlan Medical and Dental Plans? Yourself Your spouse or registered same-sex domestic partner Your dependent children up to age 26 For the dependent eligibility definition, visit www.umn.edu/ohr/benefits/eligibility/index.html
50. How do Wellness Points work? You accumulate points for participating in wellness points activities You must earn the minimum number of points by August 31, 2014: 300 points for employee-only or employee plus children 400 points for employees who cover a spouse/same-sex domestic partner Covered spouses/partners can contribute up to 100 of the 400 total points required You will receive either a $300 or $400 reduction in your 2015 UPlan Medical Program rates if you earn the required number of points
51. Will I need a referral to see a specialistwith Medica? Some Medica Plans do not require a referral to see an in-network specialist Medica Insights Medica Choice National or Regional Medica HSA Medica Elect/Essential have special guidelines No referral needed in your care system Referral needed to see an in-network provider who is not in your care system
52. Will I need a referral to see a specialist with Medica? New Medica ACO Plan You can see any primary or specialty care provider within the ACO you select Referrals outside of your ACO are unlikely For all plans, you’ll need a referral from your care system and Medica to receive in-network benefits from an out-of-network provider
53. Will I receive new Medical and Dental ID Cards? Members will receive a new Medical ID card from Medica Members will receive a new Dental ID card from Delta Dental and HealthPartners if they make a change New enrollees will receive ID cards from Medica and Prime Therapeutics if they choose a medical plan, and a dental ID card from Delta Dental or HealthPartners Dental if they choose a dental plan Replacement cards can be obtained from your health or dental plans
54. Will I receive a new FSA debit card? No. Current participants will have their new 2014 health care FSA election loaded on their current debit cards Please retain your FSA cards! New Health Care FSA enrollees will receive new FSA debit cards Replacement cards can be obtained from ADP
55. Will flu shots be available this year? Yes, seasonal flu shots will be available at no cost On campus Walk-in clinics and flu clinics On the Twin Cities campus, schedule an appointment online at www.bhs.umn.edu/public-health/flu.htm Employee Health & Benefits Fairs Your medical clinic Convenience clinics and retail pharmacies (no cost if pharmacy is in Prime Therapeutics’ network)
56. Who is eligible for the Medication Therapy Management Program? You are eligible if you take four or more medications for chronic conditions The program offers: UPlan-paid consultations with an MTM pharmacist (HSA members pay full cost of consultations) NEW: earn 100 Wellness Points if you visit your MTM pharmacist at least three times before August 31, 2014
57. How do I contact the Health Plans? Medica 952-992-1814 or 1-877-252-5558 www.medica.com/uofm Delta Dental 651-406-5916 or 1-800-448-3815 www.deltadentalmn.org/uofm HealthPartners Dental 952-883-5000 or 1-800-883-2177 www.healthpartners.com/uofm Prime Therapeutics 1-800-727-6181 www.myprime.com/MyPrime/umn Fairview Specialty Pharmacy 612-672-5289 or 1-877-509-5115 www.fairviewspecialtyrx.org/uplan