Benefits Open Enrollment - Macalester

Post on 09-Jun-2022

10 views 0 download

Transcript of Benefits Open Enrollment - Macalester

November 1st through November 16th

Jason DempsterAssociate Director of Compensation & Benefits

Kelly FangWell-being Program Manager and Certified Wellness Coach

Benefits Open Enrollment

Today’s Focus

Dental Plan Renewal

Health Plan Renewal

New Benefit Offering

Life, Long-term Disability

Retirement Plan

Wellness Program

Online Benefit Enrollment System

Questions and Answers

Dental Plan Renewal

Vendor Design

Structure Network

No Change

Service/Feature PPO Delta Premier Out of Network

Annual Maximum Benefit Unlimited Unlimited Unlimited

Annual Deductible $0 $0 $0

Diagnostic & Preventive

Exams, cleanings, x-rays, sealants

Preventive Dental

Covered at 100% Covered at 100% Covered at 100%

Service/Feature PPO Delta Premier Out of Network

Annual Max Benefit $1,500 $1,250 $1,000

Annual Deductible $0/person; $25/person; $50/person;Not applicable to preventive and

diagnostics$0/family $75/family $150/family

Diagnostic & Preventive

Exams, cleanings, x-rays, sealants

Basic Services

Fillings, Emergency treatment for pain

Endodontics, Periodontics

Root canals

Oral Surgery

Extractions

Prosthetics

Denture adjustments, repairs

Major Restoratives

Dentures, Resins, Crowns

Orthodontics

$1,000 lifetime max per child

Comprehensive Dental

Covered at 50% Covered at 50% Not Covered

Covered at 50% Covered at 50% Not Covered

Covered at 75% Covered at 50% Covered at 50%

Covered at 50% Covered at 50% Not Covered

Covered at 80% Covered at 50% Covered at 50%

Covered at 75% Covered at 50% Covered at 50%

Covered at 100% Covered at 100% Covered at 100%

Performance & Premiums

Admin

0.0%

0.0%

Type % of Expected

Preventive 94%

Comprehensive 92%

Trend

3.5%

3.5%

Total

98%

96%

Current Preventive Dental Rates

Per EE Premium

$4.64

$13.93

$21.71

Current Comprehensive Dental Rates

Per EE Premium

$26.66

$62.73

$100.48

Renewal

2019 Preventive Dental Rates

Per EE Premium $ Change per Mo % Change

$4.36 -$0.28 -6%

$13.10 -$0.84 -6%

$20.41 -$1.30 -6%

2019 Comprehensive Dental Rates

Per EE Premium $ Change per Mo % Change

$24.53 -$2.13 -8%

$57.71 -$5.02 -8%

$92.44 -$8.04 -8%

Dental Insurance Premium Changes(since 2013)

0.00% 0.00%

-1.54%

3.00%

26.61%

1.50%

-7.00%-10.00%

-5.00%

0.00%

5.00%

10.00%

15.00%

20.00%

25.00%

30.00%

2013 2014 2015 2016 2017 2018 2019

ACA Tax Form – 1095c

Health Plan DesignCOVERAGE FOR:

In-Network* Out-of-Network In-Network* Out-of-Network

Single $3,200/person $12,800/person $500/person $2,000/person

Family $6,400/family $25,600/family $1,000/Family $4,000/Family

PREVENTIVE CARE SERVICES

Routine Health Exams, Cancer Screening,

Eye and Hearing Exams, Immunizations,

Prenatal & Postnatal Services

100% of charges incurred 100% of charges incurred 100 % of charges incurred No coverage

CONVENIENCE CLINICS

Minute Clinic

ALLERGY INJECTIONS Deductible, then 100% Deductible, then 100% No out of pocket cost 60% of charges incurred

PRIMARY CARE OFFICE VISITS

MD Visits (includes ancillary services

received in provider’s office and palliative

care)

BEHAVIORAL HEALTH/SUBSTANCE

ABUSE - OutpatientDeductible, then 100% Deductible, then 100% $30 co-pay, then 100% 60% of charges incurred

URGENT CARE VISITS Deductible, then 100% Deductible, then 100% $50 co-pay, then 100% $50 co-pay, then 100%

SPECIALTY OFFICE VISITS

Chiropractic, Physical Therapy, Speech

Therapy, Occupational Therapy,

Acupuncture, etc.

AMBULANCE SERVICES Deductible, then 100% Deductible, then 100% 80% of charges incurred 60% of charges incurred

INPATIENT HOSPITALIZATION Deductible, then 100% Deductible, then 100% 80% of charges incurred 60% of charges incurred

EMERGENCY ROOM VISITS

(coverage for emergency conditions only)

Single - Medical $3,200/person $12,800/person $3,200/person $12,800/person

Family Medical $6,400/family $25,600/family $6,400/family $25,600/family

Generic Formulary Drugs

- 31 day supplyDeductible, then 100% Deductible, then 100%

$15 co-pay and then 100%

thereafter60% of charges incurred

Brand Formulary Drugs

- 31 day supplyDeductible, then 100% Deductible, then 100%

$40 co-pay and then 100%

thereafter60% of charges incurred

Specialty Drugs - Brand Non-Formulary

- 31 day supplyDeductible, then 100% Deductible, then 100%

20% co-pay up to $300 per

perscription, 100%

covered thereafter

60% of charges incurred

Mail Order - Generic Formulary Drugs

- 90 day supplyDeductible, then 100% Deductible, then 100%

$30 co-pay and then 100%

thereafter60% of charges incurred

Mail Order - Brand Formulary Drugs

- 90 day supplyDeductible, then 100% Deductible, then 100%

$80 co-pay and then 100%

thereafter60% of charges incurred

OTHER COVERED SERVICES Deductible, then 100% Deductible, then 100% 80% of charges incurred 60% of charges incurred

LIFETIME MAXIMUM Unlimited $1,000,000 Unlimited $1,000,000

ANNUAL OUT-OF-POCKET MAX

PRESCRIPTION DRUGS

Deductible, then 100% Deductible, then 100% $50 co-pay, then 100% $50 co-pay, then 100%

Deductible, then 100% Deductible, then 100% $100 co-pay, then 100% $100 co-pay, then 100%

Deductible, then 100% Deductible, then 100% $10 co-pay, then 100% 60% of charges incurred

Deductible, then 100% Deductible, then 100% $30 co-pay, then 100% 60% of charges incurred

HDHP (2019) PPO (2019)

CALENDAR YEAR DEDUCTIBLE

E-visits - virtuwell Deductible, then 100% Deductible, then 100%

The first 3 visits free, then

$10 co-pay per visit

thereafter

No coverage

Vendor Design

Structure Network

No Change

Deductibles & Out-of-Pocket Maximums Over Time

Year Deductible Out-of-Pocket Max

2012 $2,400/$4,800 $2,400/$4,800

2013 $2,500/$5,000 $2,500/$5,000

2014 $2,600/$5,200 $2,600/$5,200

2015 $2,600/$5,200 $2,600/$5,200

2016 $3,000/$6,000 $3,000/$6,000

2017 $3,000/$6,000 $3,000/$6,000

Deductible

• $3,200

Mac Contribution

• $1,722

Adjusted Deductible

• $1,478

2018 $3,200/$6,400 $3,200/$6,400

2019 $3,200/$6,400 $3,200/$6,400

Deductible

• $6,400

Mac Contribution

• $3,444

Adjusted Deductible

• $2,956

Individual

Employee+1 or Family

Health Savings Account (HSA)

Contributions are made on a

“pre-tax” basis through

payroll deductions

Health Savings

Accounts are only available to those who have elected

the High Deductible Health Plan

(HDHP)

Macalester highly funds

HSA’s through employer

contributions to your HSA

account

A HSA is a true savings

account

Does not have the “use it or lose it” clause

Health Savings Account (HSA) Contributions

Mac Monthly

Contribution

Level 1

EE Monthly

Contribution

Level 1

$100.00 $0.00

$200.00 $0.00

$200.00 $0.00

Mac Monthly

Contribution

Level 2

EE Monthly

Contribution

Level 2

$121.75 $21.75

$243.50 $43.50

$243.50 $43.50

Mac Monthly

Contribution

Level 3

EE Monthly

Contribution

Level 3

$143.50 $43.50

$287.00 $87.00

$287.00 $87.00

Open enrollment is an ideal time to review and update your HSA contributions

2019 Full-Time HSA Contributions

Max Matched

Mac

Contribution

Annual

Out-of-Pocket

Maximum

2019

IRS Limits

Max Amount for

Unmatched

Contribution

Employee Only $2,244 $3,200 $3,500 $1,256

Family $4,488 $6,400 $7,000 $2,512

Health Savings Account (HSA) Contributions

Open enrollment is an ideal time to review and update your HSA contributions

Part-Time

.50-.74 FTE

Employee Only

Employee + (1)

Employee + (2+)

Mac Monthly

Contribution

Level 1

EE Monthly

Contribution

Level 1

$80.00 $0.00

$160.00 $0.00

$160.00 $0.00

Mac Monthly

Contribution

Level 2

EE Monthly

Contribution

Level 2

$90.88 $10.88

$181.75 $21.75

$181.75 $21.75

Mac Monthly

Contribution

Level 3

EE Monthly

Contribution

Level 3

$101.75 $21.75

$203.50 $43.50

$203.50 $43.50

Max Matched

Mac

Contribution

Annual

Out-of-Pocket

Maximum

2019

IRS Limits

Max Amount for

Unmatched

Contribution

Employee Only $1,482 $3,200 $3,500 $2,018

Family $2,964 $6,400 $7,000 $4,036

2019 Part-Time HSA Contributions

Health Insurance Factors

Inpatient

Hospital

Outpatient

Hospital

Pharmacy High Cost

Claimants

Ambulance

Type % of Expected

HDHP 77%

PPO 86%

Admin

-26.04%

-26.04%

Trend

-3.15%

-0.30%

Regression

3.12%

3.12%

Reserve

-28.00%

-28.00%

2019 Health Insurance Rates(full-time)

Current Full-Time HDHP Rates

Tier Per month EE PremiumEE Only $112.93EE+1 $340.08EE+(2+) $496.65

Current Full-Time PPO Rates

Tier Per month EE PremiumEE Only $165.08EE+1 $501.72EE+(2+) $734.23

Renewal

2019 Full-Time HDHP Rates

Per EE Premium $ Change per Mo % Change$96.50 ($16.43) -15%

$287.31 ($52.77) -16%$418.82 ($77.82) -16%

2019 Full-Time PPO Rates

Per EE Premium $ Change per Mo % Change$145.14 ($19.94) -12%$438.01 ($63.70) -13%$640.30 ($93.93) -13%

2019 Health Insurance Rates(part-time)

Current Part-time HDHP Rates

Tier Per EE Premium

EE Only $221.85

EE+1 $564.13

EE+(2+) $825.08

Current Part-Time PPO Rates

Tier Per EE Premium

EE Only $326.17

EE+1 $833.53

EE+(2+) $1,221.06

Renewal

2019 Part-Time HDHP Rates

Per EE Premium $ Change per Mo % Change$188.00 ($33.86) -15%$475.51 ($88.62) -16%

$694.71 ($130.37) -16%

2019 Part-Time PPO Rates

Per EE Premium $ Change per Mo % Change$285.29 ($40.88) -13%$726.69 ($106.84) -13%

$1,063.84 ($157.22) -13%

Health Insurance Premium Changes(since 2010)

0.00%

2.91%

0.00%

-8.35%

-5.50%

7.64%

13.91%

6.56%

3.50%

-14.00%

-20.00%

-15.00%

-10.00%

-5.00%

0.00%

5.00%

10.00%

15.00%

20.00%

2010 2011 2012 2013 2014 2015 2016 2017 2018 2019

Health Insurance Comparison

Step 1

Select Status

Full-Time

Step 2

Select Level of Coverage

Employee Only

Step 3

Select HSA Contribution

Level 3

Step 4

# of Months of Coverage

12

Per Mo Rate # of Months Total Per Mo Rate HSA Credit # of Months Total

Premiums 145.14$ 12 1,741.68$ 96.50$ 12 1,158.00$

PPO HDHP

Co-Pay's/Visit Expense -$ 1 -$ -$ 1 -$

Out-of-Pocket Max

Total 1,741.68$ 1,158.00$

$3,200 $3,200

EE HSA Contribution -$ 12 -$ 43.50$ 12 522.00$

Mac HSA Contribution 143.50$ 12 1,722.00$

(564.00)$

Difference 2,305.68$

Co-Pay's/Visit Expense 100.00$ 1 100.00$ 1,000.00$ 1 1,000.00$

Out-of-Pocket Max

Total 1,841.68$ 2,158.00$

$3,200 $3,200

Difference 1,405.68$

If interested in looking at which option would work best for you and your family, contact Jason @ x6454

Health Insurance

$0.00$49

$103 $161

$175

$300

$750

Average Expense Per Visit

Ways to Reduce Health Care Costs

See your Doctor

Avoid Reactive Care

Save Emergency Room for

Emergencies

Take Care of Yourself

Practice Safety & Healthy Habits

Ways to Reduce Health Care Costs

$3,700 Minute Clinic

$3,750

ER Visits

$18,200 Urgent

Care Visits

$56,189 Primary

Care Visits

$680 Urgency

Room Visits

497 Visits

Savings of

$82,519

How Works

Log onto healthpartners

.com

Click on Start my visit in

Online care

Enter symptoms

Nurse Practitioner diagnoses

and creates treatment

plan within 30 minutes

Prescription sent to

pharmacy of choice

Pay for treatment.

No more than $49

Feel Better!

Conditions Treats Allergies

Bugs & Bites

Cold, Cough & Flu

Ear pain or infection

Pink Eye or Stye

Skin & Rashes (acne, cold sore, eczema, shingles, chicken pox, rosacea, poison ivy, hives, athlete’s foot)

STI/Sexual Health

Women’s Health (birth control & infections)

Ways to Save on Prescriptions

Ask About Generics

Ask for a Discount

Listen to Your Doctor

Shop Around

Try Mail-Order Medications

Visit the Manufacturer’s

Website

An Innovative Solution

Medicine is expensive

Don’t know how much

Costs vary greatly

An Innovative Solution

New online experience

Personalized communications

Guide to choices and alternatives

Better understanding of pharmacy costs

Member ExperienceLogin Open Explore

Mobile Member Experience

Login Open Explore

Explore Prescriptions

Ways to Save

Ways to save

Bundled savingsopportunity

Employee Assistance ProgramMacalester provides cost-free professional consultation and referral services for employees who are experiencing work and personal-related difficulties

Confidential consultation is provided including:

Work relationships Conflict resolution

Mental health Interpersonal relationships

Family Loss and bereavement

Alcohol/substance abuse Finding child or elder care

Financial information, resources and tools

Legal information, resources and consultations

Benefits with No Changes

All FSA participants must

re-enroll annually

during open enrollment!

New Benefit: Identity Protection

Eligibility

• Staff and faculty with 0.50 – 1.00 FTE

2019 Monthly PremiumsCoverage Premium

Individual $8.95/mo.Family $16.95/mo.

3 Bureau Credit

Monitoring

Alerts

Unlimited Consultation

Mobile App

24/7 Assistance

Comprehensive Identity

Restoration

New Benefit: Sick Time Donation

Life, LTD & STD RenewalPast

For the last 9 years

Premiums decreased or remained the same

Current:

Basic Life: Loss ratio of 231%

LTD: Loss ratio of 159%

STD: Loss ratio of 102%

Goal of better

renewal

Leverage competition

Sent requests to

other vendors

Markeredour plans

Cost Type

Optional Life/AD&D

Dependent Life

Short-Term Disability

Long-Term Disability

Basic Life/AD&D

% Change

0%

0%

19%

69%

33%

Payor

Employee

Employee

Employee

Macalester

Macalester

Goals for Retirement Plan Enhancements

Reduce administrative requirements

Streamline and simplify investment

options

Reduce Fees for

participants and the plan

Enhance the user

experience

Retirement Plan Enhancements

Combine Two Recordkeepers

• TIAA

• Vanguard

TIAA

• Sole Recordkeeper

Reduced Fees

• Better share classes

• Less Recordkeeping Fees

• Lower expenses for participants

Retirement Fund Enhancements

Reduce Fund Options

• Current =111 funds

• New = 29 funds & Brokerage Window

“Best-in-Class” Fund Line-up

• Consistent performance within fund class

• Low expenses

Offer Mutual Fund Window

• Expansion of options

• Select what is wanted

• Keep current funds

Retirement Plan Enhancements Timeline

September 2018

• Announcements begin

• Continue through January 2019

November 2018

• Group Educational Sessions

• Individual counseling

• New line-up LIVE

December 2018

• All future contributions sent to TIAA

• Mapped to corresponding fund type

January 2019

• Vanguard balances move to TIAA

• Mapped to corresponding fund type

No Action Required

• Unless different funds wanted

• Or want to retain a fund that is changing

Wellness 2019

Move to Calendar Year

Health Assessment

Feb-Oct

New Wellness Portal & Platform

Wellness Coach @ 4

Days

Increase Incentives

Increase Participation

Wellness Premiums

Year Employee Macalester Collected Expense

2018 $4/mo $16/mo $127,920 $136,976

2019 $5/mo $20/mo $159,900

Well-being for

Staff & Faculty

Kelly Fang

Well-being Program Manager & Certified Wellness Coach

WELL

Statement of Purpose & Belief

“At Macalester College we believe that education is a fundamentally transforming experience. As a community of learners, the possibilities for this personal, social, and intellectual transformation extend to us all.”

Inspired

56%

48% 48%

22% 22%19%

2016 2017 2018

257HA completions

in 2018

140Participants in

3-yr cohort

104Program completions

Informed

Health assessments ≥ 1 Program

Informed

Quality of life

• Physical health concerns (no change)

• Emotional concerns(5% better)

• Back pain (3% better)

• Low life satisfaction (8% better)

• Low job satisfaction (6% better)

Informed

Modifiable health factors

• High risk for diabetes

or heart disease (6% rise)

• Obesity (2% rise)

• Low physical activity (8% rise)

• Few fruits & vegetables (2% rise)

Informed

Modifiable health factors

• Tobacco use (1.5% rise)

• Suboptimal sleep (2% rise)

• Unhealthy stress (4% rise)

ConfidentCalmStrong

166 members sought physical therapy in 2017

Physicians Neck and Back Centers Lunch & Learn

WHAM activity classes

Personal trainer Jamie Ochsenwald

Health coaching with Kelly Fang

Strong

17% report difficulty managing stress (Among Macalester employees who completed the health assessment)

Self-Compassion & Resiliency Lunch & Learn

Mindfulness classes

NEW Healthy Thinking online program

Employee Assistance Program (EAP)

Calm

Confident

Macalester College Preventive Care Gaps

26%

AT RISK FOR DIABETES

25%

NOT ADHERENT TO THEIR MEDS

23%

OVER AGE 45 DID NOT SEE A PRIMARY

CARE DOCTOR

26%

OVERDUE FOR A COLONOSCOPY

20%

OVERDUE FOR A MAMMOGRAM

Among all members, employees and spouses

Annual Health Assessment

Annual Preventive Care Visit

Disease & Case Management Phone Coaching

NEW Choose to Lose online program

NEW Well-being Challenges

Confident

Your new online and mobile experience

56

Energized

Additional resources

Talk with a nurse

Support 24/7, 365 days a year at no cost to you.

Learn more

Healthy Living blog

The latest health trends and advice from our healthy living experts.

Learn more

Helpful links

Custom link 1Custom link 2Custom link 3Custom link 4Custom link 5

Activity options

Reward information

Between February 1 – October 31, 2019

www.healthpartners.com/wellbeing

58

Complete your health assessmentStep 1

Energized

Health assessment

59

Confidential

Quick

Easy

Well-being Prize Drawings:

60

Complete your health assessment

Complete an activity of your choice

Step 1

Energized

• $500 credit towards a new bike

• Free domestic airline ticket

• Week of meals & groceries from a personal chef, and

more!

Step 2

Your activity options

12

Online/Mobile At Work Phone

WHAM 6-week Class

Health Coaching

NEW: Sugar Shake-Up Challenge (Jul. ‘19)

NEW Path: Paths to Positivity (Oct. ‘18)

NEW: Lose Weight in 8 Challenge (Feb. ’19)10,000 Steps

NEW Choose to Lose

NEW Healthy Thinking

Disease and Case Management (DCM)

Phone Coaching

Stress Tracker

Sleep Tracker

NEW Go for Fruits & Veggies

Beating the Blues

The more activities you complete the more chances you

have to win!

Complete all three steps to earn a one month

well-being premium holiday valued at $96.50 (employee only monthly premium rate for the high deductible health plan)

62

Complete your health assessment

Complete an activity of your choice

Complete your annual preventive visit*

Step 1

Energized

Step 2

Step 3

*Only preventive care visits completed between

September 1, 2018 and August 31, 2019 will qualify, to

allow time for processing.

No tracking or forms are required on your part!

Well-being premium holidays will be awarded in April,

July, September & December 2019.

63

Complete your annual preventive visit*Step 3

Energized

For details visit: macalester.edu/wellness

Schedule your annual preventive care visit today!

On February 1, 2019, log on to:

healthpartners.com/wellbeing

Online Enrollment Process

Visit macalester.bswift.com

Username: Mac Username (first part of email address),

Password: Previously established personal password

Click on Start Your Enrollment

Once complete with elections, check the I agree, and I’m finished with my enrollment box

Click on Complete Enrollment to finalize your enrollment

Online Enrollment Process

Once your enrollment is complete, you may choose to view, email or print a confirmation statement

By clicking on the home button, you will see the status of your enrollment as complete.

You have the option to make changes to your benefits if it is before 11/16/2018 by clicking Change by Elections on the home screen. Follow the prompts to make the necessary changes

To confirm whether you have completed your benefit enrollment, log in the new benefit enrollment system located at macalester.bswift.com. Once logged into your home landing page, a message in the upper left hand corner will say your enrollment is complete or Start Your Enrollment.

After the open enrollment period closes on 11/16/2018, you will receive an email to prompt you to review your benefit enrollment. Benefit confirmation statements will not be mailed.

Online Enrollment Process

If your 01/01/2019 benefit statement does not reflect your intentions, you have until 11/21/2018 at 4:00 PM

To contact Jason Dempsterat jdempste@macalester.edu or call 651-696-6454 to resolve any discrepancies.

No changes will be accepted after 11/21/2018.

Available at: macalester.edu/hr

Online Open Enrollment Guide

Link to online benefit enrollment system

2019 Open Enrollment Summary

Detailed Individual Benefit Information

Resources

Benefits Fair• Wednesday, October 31, 2018• 10:00 AM to 3:00 PM• Weyerhaueser Boardroom & Lounge

• Meet and talk directly with representatives from our benefit vendors and obtain answers to your benefits questions

• Attend the Benefit Fair and enter raffle for a chance to win prizes from benefit vendors

Questions?

Open Enrollment is November 1st through November 16th