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2015 Medical Plan Options, Health Savings Accounts & Flexible Spending

2015 Medical Plan Options, Health Savings Accounts & Flexible Spending. Presented to: Presented By: Greg Biese Vice President, Senior Benefits Consultant. Associated Financial Group Employee Benefits. Insurance. HR Solutions. HealthCare Reform: Yesterday, Today & Tomorrow.

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2015 Medical Plan Options, Health Savings Accounts & Flexible Spending

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  1. 2015 Medical Plan Options, Health Savings Accounts & Flexible Spending Presented to: Presented By: Greg Biese Vice President, Senior Benefits Consultant Associated Financial Group Employee Benefits. Insurance. HR Solutions.

  2. HealthCare Reform: Yesterday, Today & Tomorrow St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  3. 2015 Medical Eligibility & Rates St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  4. 2015 Benefit highlights St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  5. 2015 Benefit highlights (cont.) St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  6. PPO plan effective January 1, 2015 (1) Due to Health Care Reform changes, beginning in 2015, all copays, including pharmacy copays, will apply to the out-of-pocket maximum. St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  7. Preventive Services St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  8. Diagnostic Services • Diagnostic services are generally not covered under the preventive care benefit but may be covered under another portion of your medical benefit plan. • Services are considered diagnostic when a person: • Has abnormalities found on previous preventive or diagnostic services that require further diagnostic services; or • Had abnormalities found on previous preventive or diagnostic services that would recommend a repeat of the same service within a shortened time period from the recommended preventive screening time period based on age and gender; or • Had a symptom(s) that required further diagnosis St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  9. What Exactly is an HSA? PART 1: HIGH DEDUCTIBLE HEALTH PLAN (HDHP) Intended to cover serious illness or injury once the deductible is met. HSA PART 2: HEALTH SAVINGS ACCOUNT (HSA) Used to cover expenses until the deductible is met. TWO PARTSTO AN HSA St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  10. Important Information Regarding Your HSa / High Deductible Health Plan (HDHP) St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  11. Important Information Regarding Your HSa / High Deductible Health Plan (HDHP) The deductible and coinsurance out-of-pocket maximum for family is a true family deductible and out-of-pocket maximum. St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  12. Who is Eligible for HSA’s? Any employee that: • Is covered by an HDHP • Is not covered by another non-HDHP health plan • Is notenrolled in Medicare • Cannot be claimed as a dependent on someone else’s tax return St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  13. Advantages of an HSA St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  14. HSA Annual Contributions – 2014 • Annual contributions to the HSA are limited to $3,300 single / $6,540 family (2015 will be released in late summer) • Benefits are subject to federal regulations • Deductibles, out-of-pocket and contribution maximums are determined annually • Account holders age 55 and up may make additional contributions of $1,000 in 2014. St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  15. Contributing to Your HSA • You can elect how much money you want to put into your HSA. • It is your responsibility to ensure that you do not exceed the maximum HSA contribution limit. • Your employer will deduct this amount on the date of each payroll on a pre-tax basis and the money will be direct-deposited to your HSA account. • You may also deposit funds directly into your bank account with post-tax dollars and claim the amount on your tax return. St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  16. Who Determines Whether HSA Distributions are Used Exclusively for Qualified Medical Expenses? • YOU! • Your bank will submit information to the IRS each year to report contributions and withdrawals. • You will need to report withdrawals on your federal income tax forms. • Individuals who establish HSAs should maintain records of their medical expenses to show that the distributions have been made exclusively for qualified medical expenses. St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  17. HSA Withdrawals/Distributions • Federal tax treatment of funds used: St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  18. Eligible Medical Expenses for Tax-Free Distributions • Qualifying medical expenses - IRS Publication 502 • Dental and vision care expenses • Long-term care insurance • Premiums for coverage while receiving unemployment compensation St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  19. Bank Information St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  20. Ways to Be a More Cost Conscious Consumer of Health Care • Get Healthy and Stay Healthy! • Use Appropriate ‘Levels of Care’ – Fast Care/Urgent Care/Emergency Room • Use In-Network Providers • Consider Generic or Mail Order prescriptions • Consider $4 Generic Programs at Target & Wal-Mart Stores • Ask doctors and pharmacists questions • Most effective treatment • Cost of treatment • Alternatives to treatment • Support and participate in company sponsored wellness and disease management initiatives St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  21. Levels of Care Sample COST $500+ $200+ $125+ $49-$69 $0 Emergency Room Complex chest pain, trauma Available extended hours & weekends Urgent Care Clinic Sprains, strains, sutures; typically hospital-based Available extended hours & weekends Primary Care Provider Wellness/preventive/screening services, comprehensive management of acute and chronic conditions Available extended hours & weekends in some cases Convenience – Walk-In Care Clinic Colds, flu, quick service Available extended hours & weekends Nurse Line Health and first aid questions, premium provider search, guidance on appropriate facility and location to meet care needs No Cost Available 24/7 St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  22. Prescription Cost and Savings Opportunities - $4 Prescriptions WHAT IS IT? Many retail pharmacies have recently created new and innovative programs to help control prescription drug costs for consumers. One of the most popular is the $4 prescription drug program, which has allowed consumers to take advantage of tremendous savings for their everyday prescriptions needs. This program is offered at many national and regional pharmacies, including those shown above, and typically includes hundreds of medications in a variety of therapeutic classifications. Other programs that may be available in your area may include free antibiotics and various 90-day supply discounts for maintenance medications. Many pharmacies also have low-cost membership programs that allow you to access significant savings. It is likely that there will be new programs and enhancements to existing programs in the future as pharmacies continue to compete for the right to fill your prescriptions. Interaction with insurance - continue to provide your insurance information to ensure you receive the deepest discount and that your coinsurance is applied to your deductible and/or out-of-pocket maximum. If your insurance company has negotiated a deeper discount than $4 (or the pharmacy’s discount rate) for the prescribed medication, you will be charged the lesser of the two prices. KEEP MONEY IN YOUR BANK! 21 St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  23. Health Savings Accounts (HSA) and Flex Spending Accounts (FSA) St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  24. Flexible Spending Account (FSA) UpdateNew Plan Administrator 9.1.2014 Employee Benefits Corporation (EBC) will replace M&I (BMO Harris) as your FSA Administrator Your current FSA plan year will end on 8.31.2014. Please continue to submit all claims to M&I (BMO Harris) for reimbursement. You will have 90 days after the end of the current plan year to submit claims incurred between 9.1.2013 through 8.31.2014. • We will running a ‘short’ plan year (9.1.2014 to 12.31.2014) • Your next plan year will start on January 1, 2015 What does this mean for you? • Enrollment Forms will be required effective 9.1.2014 and then again effective 1.1.2015 St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  25. FSA Short Plan Year (9.1.2014 – 12.31.2014) The short-plan year (4 months) will allow you to submit claims incurred between 9.1.2014 and 12.31.2014. Please keep in mind the following: • The Health Care FSA maximum for the ‘short plan year’ must be pro-rated. Participants will be allowed to contribute 1/4th of the annual limit of $2,500. • 1/4th of the Annual Limit is $833.33 • The Dependent Care FSA limit is $5,000 per calendar year. To calculate your allowable amount subtract your 2014 contributions (January 1st - through August 31st ) from the $5,000 annual limit. Example 1: Between January 1st – August 31st, Jane Smith contributed $4,000 to her Dependent Care FSA account. She may contribute an additional $1,000 to her Dependent Care FSA between 9.1.2014 – 12.31.2014 Example 2: Jane Smith did not participate in the Dependent FSA in the 2013-2014 Plan Year. She may contribute up to $5,000 to her Dependent Care FSA account between 9.1.2014 – 12.31.2014 . Jesse will be sending additional communication regarding these changes to the SNC community in May 2014. St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  26. EBC Features: Submitting claims is EASY My Mobile Account Assistant • For Android and iPhone • Camera scans documentation • Upload with claim information • Receive notification when a claim is processed • Use the app to review FSA account information Submit claims online or using paper • My Account Assistant • Your secure web portal lets you review all aspects of your account online at www.ebcflex.com • Submit claims and documentation • Receive notification when a claim is processed • Claim Form • Mail or fax a paper form with attached documentation St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

  27. Questions? St. Norbert College/14/Misc/2015 Plan Options & HSA Education.pptx

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