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Open Enrollment 2006

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  1. Open Enrollment 2006 Office of Human Resources Benefit Services

  2. Agenda • Communication Materials • Open Enrollment Options • Open Enrollment Online! • Select-Term Disability • Benefit Plans • Changes and Premiums • Your Plan for Health • Questions

  3. Open Enrollment 2006 October 31 – November 18, 2005 Benefit Changes Effective: January 1, 2006 through December 31, 2006

  4. Communications

  5. Open Enrollment 2006 • Overview • Health Benefits • FSA Benefits • Contribution Rates • Your Plan for Health Communications 2006 Open Enrollment Brochure Contents: • Open Enrollment Overview • Health Benefits • Health Plan Contribution Rates • Flexible Spending Accounts (FSA) • Your Plan for Health Sent to home address during last week in October

  6. Benefits Eligibility byAppointment Classification Regular Post-Doc Researcher Auxiliary Faculty Special A Clinical Instructor Special B Post-Doc Fellow Returning Retiree http://hr.osu.edu/hrpubs/ben/eligibilitysymbols.pdf

  7. Open Enrollment Options Enroll: • Medical, Dental, Vision • Flexible Spending Accounts Make Changes: • Medical Plans • Add or Drop Dependents, Based on Eligibility • Review Dependents Currently Enrolled • Drop Current Health Coverage or Select-Term Disability Coverage

  8. “Open Enrollment Online!” • Online Enrollment for: • Medical, Dental, Vision • Flexible Spending Accounts • Advantages of Online Enrollment • “One-Stop Shop” for All Your Needs! • Accessible 24 hrs During Open Enrollment • Immediate E-mail Confirmation of Receipt of Elections http:/hr.osu.edu/oe

  9. “Open Enrollment Online!” • Login Method: • OSU User Internet ID (last name.#) • Password designated for this account • Not yet activated – link from Open Enrollment Online! home page to establish ID & password • To reset password – contact OIT at 688-HELP (4357) for assistance

  10. New Feature!! $171.27 $26.21 $17.44 $214.92

  11. New Feature!! $171.27 $26.21 $17.44 $214.92

  12. Confirmation Screen with Election Summary

  13. Select-Term Disability Rate Changes Effective January 1, 2006

  14. Select-Term Disability • Current Enrollees May Drop Coverage During Open Enrollment • Available online at: • Select-Term Disability Election Form Must Be Completed to Drop Coverage http://hr.osu.edu/Forms/Ben/disabilityenrollment.pdf

  15. Medical Plans Overview

  16. Medical Plans • University Prime Care (UPC) • Regional University Prime Care (RUPC) • Temporary Out-of-Area Benefit • OSU Health Plan (OSUHP) • Traditional Health Plan (THP) • Buckeye Health Plan (BHP)

  17. University Prime Care (UPC)Regional University Prime Care (RUPC) • Primary Care Physician Required (UPC only) • Deductible -None • Coinsurance - None (most services) • Office Visit - $15 Copay • Specialists - $25 Copay • Emergency Room - $100 Copay • Hospitalization & Outpatient Surgery-$250 Copay • Annual Out-of-Pocket Max- $2,000 Per Person

  18. UPC/RUPCMonthly Employee Contributions

  19. Temporary Out-of-Area Benefit • Deductible - $500 Per Person • Coinsurance - 20% (most services) • Emergency Room - $100 Copay • Hospitalization–20% • Annual Out-of-Pocket Max - $2,500 Per Person

  20. OSU Health Plan (OSUHP)(Network Coverage)( • No Primary Care Physician Required • Deductible - None • Coinsurance - None for Most Services • Office Visit - $15 Copay • Specialists - $25 Copay • Emergency Room - $100 Copay • Hospitalization & Outpatient Surgery-$250 Copay • Annual Out-of-Pocket Max - $2,000 Per Person

  21. OSU Health Plan(Non-Network Coverage) • Deductible - $500 Per Person • Coinsurance -30% (most services) • Emergency Room - $100 Copay • Hospitalization -30% to $2,000 • Does not apply to out-of-pocket maximum • Annual Out-of-Pocket Max- $2,500 Per Person

  22. OSU Health Plan (OSUHP)Monthly Employee Contributions

  23. Traditional Health Plan (THP)(Non-Network) • Deductible - $500 Per Person • Coinsurance - 20% (most services) • Emergency Room - $100 Copay • Hospitalization-$250 Copay • Annual Out-of-Pocket Max - $2,500 Per Person

  24. Traditional Health Plan (THP)Monthly Employee Contributions

  25. Buckeye Health Plan (BHP)(Non-Network) • Deductible - $500 Per Person • Coinsurance - 20% (most services) • Emergency Room - 20% • Hospitalization - 20% • Annual Out-of-Pocket Max - $2,500 Per Person

  26. Buckeye Health PlanMonthly Employee Contributions

  27. Dental Plan • No Plan Changes • 18-Month Plan Year continues through the end of 2006 (December 31, 2006) • Deductible - $60 per person • 18-Month Benefit Maximum • One-half annual benefit maximum for 2005 ($600) + Annual benefit maximum for 2006 ($1,200) = $1,800 (per person) – available any time during 18-month period

  28. Dental Plan Monthly Employee Contributions

  29. Vision Plan Monthly Employee Contributions No Change to Benefit Coverage

  30. Flexible Spending Accounts • Expenses must be incurred during the 2006 plan year • Current participants must re-enrolleach plan year • Minimum reimbursement request - $25 • $5,000 limit in each account per plan year • Health Care FSA and Dependent Care FSA funds maintained in separate accounts • Detailed list of eligible and ineligible expenses: http://hr.osu.edu/benefits/healthflex.htm

  31. Your Plan for Health Our Ultimate Goal: For Everyone to be Healthier!

  32. Your Plan for Health • Ohio State’s long-term plan of health awareness and personalized health management • Capitalizes on the strengths of the university’s resources for wellness and healthy living • Rewards employees for making good health choices • Offers tools and resources that guide you toward new ways of behaving and thinking about your health

  33. Prescription Drug Management • No deductible at retail pharmacy • Generic copays reduced • Employee costs for brand name drugs aligned at retail and mail order • Financial protection of out-of-pocket maximum - $2,000 per person • More counseling and support for patients taking specialty drugs

  34. Prescription Drug Benefits

  35. Personal Health Assessment (PHA) • Your Plan for Health will introduce a powerful new health tool • Online survey about your health and lifestyle • User-friendly • Voluntary • Available to all benefit-eligible employees and their enrolled dependents over age 18 • Confidential! • Information will not be sent to your employer • Will be integrated with your lifetime medical record at OSU Medical Center

  36. PHA – What will it do for you? • Provide you with a personalized health profile • Help you to identify if you are at risk for certain conditions and take steps to avoid or delay the onset of illness • Offers recommendations for your improved well-being • Provide your doctor with information useful in treating you • $50 gift card incentive to those who complete PHA with biometric data between Jan.1 and June 30, 2006.

  37. Health Management Services Your Plan for Health will enhance existing programs and provide treatment alternatives for healthier living • Include a benefit for medical massage therapy and acupuncture (musculoskeletal coverage) • Enhance the weight management program • Increase the benefit for tobacco cessation

  38. Musculoskeletal Coverage • New benefit for medical massage as an alternative to physical or occupational therapy • New benefit for acupuncture as an alternative to chiropractic treatment

  39. Weight Management • Hospital Based, Physician Directed Programs: • Pre-certification Required • Network Provider – OSU Comprehensive Weight Management Program • Weight Watchers™: • No Pre-certification Reimbursement for Both Programs: • 50% of MHCS fee schedule/UCR up to a $1000 annual maximum • Applies to Weight Loss Surgery & Related Services lifetime maximum of $25,000 • Submit proof of payment and attendance

  40. Weight Management (cont) 3. Enhanced Nutrition Benefit • Provides 3 visits with a Registered Dietician at no patient cost • Additional 3 visits after pre-certification • Network plans: $15 copayment • Non-network plans: subject to deductible and coinsurance

  41. Tobacco Cessation Program • Your Plan for Health will enhance the incentive to quit using tobacco • New benefit program paid through the medical plan will provide • $120 total maximum reimbursement for program completion • $60 for OTC patches, gum, lozenges • $60 for program • Generic prescription drugs will be more affordable under new plan • $5 retail/$10 mail order, no deductible

  42. Health Coach/Care Coordinator Support Your Plan for Healthwill introduce a brand new health and condition management approach Health Care Continuum Chronic Illness At Risk Healthy Care Coordinator Health Coach Services to be effective July 1, 2006

  43. Health Coach Available to anyone who has completed a PHA One on one support and education Wellness resource education Wellness coaching in modifying behaviors Help members meet their individual needs Care Coordinator Available to those at high risk or have a high risk for chronic conditions Typically RN’s, clinical pharmacists or other health care specialists Work one on one to support treatment plan in addition to doctor’s care Serves as a resource and advocate for patient Health Coach/Care Coordinator Support

  44. Be Sure to Read the Newsletters “Your Plan for Health ” for Updates and Additional Plan for Health Details

  45. Columbus Campus: Tuesday, November 8 9 a.m. 240 Scott Hall Monday, November 14 11:30 a.m. 1590 North High Street Room 425A Hospitals: Thursday, November 3 3:30 p.m. 112 Meiling Auditorium Tuesday, November 15 3 p.m. OSU East – Wallace Auditorium Open Enrollment Forums Open Enrollment Presentation may also be seen online athttp:/hr.osu.edu/oe

  46. Regional Campuses: Lima Monday, November 7 11 a.m. 212/213 Public Servicing Bldg. Mansfield Thursday, November 10 2 p.m. 117 Bromfield Hall Marion Friday, November 4 Noon and 2:30 p.m. 290 Morrill Hall Newark Tuesday, November 8 2 p.m. Founders Hall Auditorium Open Enrollment Forums • Wooster • Thursday, November 10 • 10 a.m. • Fisher Hall Auditorium Open Enrollment Presentation may also be seen online athttp:/hr.osu.edu/oe