Open Enrollment Highlights Setting the Stage for 2012 Health Care Review Health Plan Choices for...
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Transcript of Open Enrollment Highlights Setting the Stage for 2012 Health Care Review Health Plan Choices for...
Open Enrollment Highlights
Setting the Stage for 2012 Health Care
Review Health Plan Choices for 2012
Introduce New Flexible Spending Account administrator
Resources for enrollment decision-making
Important to enroll: review changes to plans/premiums; certify tobacco user status for medical and term life insurance
On line enrollment through E-Benefits
October 24 – November 24, 2011 (firm deadline)
Flexible Benefits
Pre-Tax Annual Choice
Making
Core Benefits
No annual election
Benefit provided to all eligible employees
University contributes portion of the cost
Voluntary Benefits
Group rates Payroll
deductions Employee pays
full cost
Core Benefits
Long Term Disability Basic Accidental Death and Dismemberment Basic Employee Term Life Insurance Retirement
Flexible Benefits
Medical Flexible Spending Accounts◦Health Care FSA◦Dependent Care FSA
Short Term Disability Additional Term Life (Employee, Spouse,
Child) Additional Accidental Death &
Dismemberment (Employee, Spouse, Child)
Voluntary Benefits
Accident Insurance Dental Insurance Critical Illness
Insurance Home/Auto Insurance Group Legal Plan Universal Life
Insurance
Voluntary Benefits
Accident Insurance Dental Insurance Critical Illness Insurance Home/Auto Insurance Group Legal Plan Universal Life
Insurance
Annual Dental Rates
Pressure from increasing costs and tight budgets shape 2012 options
2000 $ 54,010,667 2002 $ 64,393,663 2004 $ 74,964,501 2006 $ 92,429,490 2008 $111,250,048 2010 $140,445,094
2011 Premiums
Employees◦$14,400,000 (11%)
Purdue◦$120,000,000 (89%)
Legislation passed in 2011◦K-12 school corporations required to maintain
their health care costs within a certain range or they would be required to join the state’s health plans.
◦An amendment to include Higher Education was drafted by lawmakers but never introduced in committees.
Legislation introduced in 2005◦Suggested state institutions join Medco, the
state’s prescription purchasing vendor.
Legislation passed in 2011 ◦All higher education institutions join Medco.◦ Impact on Purdue:
Employee’s on the Choice plan will be migrated to Medco (from CIGNA) effective Jan. 1, 2012.
Type of Plan State of Indiana Premium EE only
Purdue EE Only Low TierBelow $44k
Purdue EE Only Higher Tier$44k or Above
High Deductible 1
$354 Not offered Not offered
Type of Plan State of Indiana Premium EE only
Purdue EE Only Low TierBelow $44k
Purdue EE Only Higher Tier$44k or Above
High Deductible 1
$354 Not offered Not offered
High Deductible 2(Choice)
$524 $155 $515
Type of Plan State of Indiana Premium EE only
Purdue EE Only Low TierBelow $44k
Purdue EE Only Higher Tier$44k or Above
High Deductible 1
$354 Not offered Not offered
High Deductible 2 (Choice)
$524 $155 $515
Traditional PPO(Purdue Incentive)
$2,958 $286 $742
Type of Plan State of Indiana Premium EE only
Purdue EE Only Low TierBelow $44k
Purdue EE Only Higher Tier$44k or Above
High Deductible 1
$354 Not offered Not offered
High Deductible 2 (Choice)
$524 $155 $515
Traditional PPO(Purdue Incentive)
$2,958 $286* $742*
(Copay Plan)Not offered $531 $977* Family $912
$2,159
No Part-time eligibility.◦Must work 37 ½ hours or more per week
No Same Sex Domestic Partner coverage. No salary tier. The State has just two coverage levels.◦ Employee Only
◦ Family
Try to reduce increases by healthy lifestyles and good consumer habits
Increase Premiums
Plan Design◦Deductibles◦Co insurance or Co pays◦Out of pocket maximums◦Incentives to use lower cost providers
Plan Pays 100%
EE Deductible
EE Co-insurance Share
Plan Co-insurance Share
Out of Pocket Maximum
Premium
Co Pays $15 to 30 per visit in network for office visits
Deductible $250 EE$500 family* Hospital In and Outpatient
Co Insurance 15% in network (30% out)
Out of Pocket Maximum
$1,200 EE$2,400 family* In network
Co Pays $15 to 30 per visit in network for office visits
ER CoPay $200 ($150)MRI, CT $200 ($50)
Deductible $250 EE$500 family* Hospital In and Outpatient
Co Insurance 15% in network (30% out) 20% in network
Out of Pocket Maximum
$1,200 EE$2,400 family* In network
• Premium increase 30%
Tiered lab network•Quest, MidAmerica, LabCorp $0•In Network Lab 30%•Out of Network Lab 50%
If your doctor does not normally send lab work to a Tier 1 lab, ask the doctor to give you a lab order form, so that you may go to another lab to have the work done.
Watch for more info Arrangements are
underway to contract with national laboratories:
Quest LabCorp Mid America
(PUSH is a draw site for Mid America Labs)
Under 44,000
Difference Over 44,000
Difference
Employee Only $690 $159 ($3/wk)
$1270 $293 ($6/wk)
Employee & Children
$1201 $277 ($5/wk) $2097 $484 ($9/wk)
Employee & Spouse
$1745 $403 ($8/wk) $3051 $704 ($13/wk)
Family $2113 $488 ($9/wk) $3687 $951 ($18/wk)
Deductible $500 EE$1,000 family* In network
Co Insurance 15% in network (40% out)
Out of Pocket Maximum
$2,000 EE$4,000 family* In network
Deductible $500 EE$1,000 family* In network
Co Insurance 15% in network (40% out) 20% in network
Out of Pocket Maximum
$2,000 EE$4,000 family* In network
$2,200 EE$4,400 Family*in network
• Premium increase 15%
Tiered lab network•Quest, MidAmerica, LabCorp $0•In Network Lab 30%•Out of Network Lab 50%
Under 44,000
Difference Over 44,000
Difference
Employee Only $329 $43 ($<1/wk) $853 $111 ($2/wk)
Employee & Children
$598 $78 ($1.5/wk) $1411 $184 ($3.5/wk)
Employee & Spouse
$869 $113 ($2/wk) $2055 $268 ($5/wk)
Family $1049 $137 ($2.6/wk)
$2483 $324 ($6/wk)
No deductible Retail: ◦Generic 20% co-insurance◦Preferred Brand 30% co-insurance◦Non-preferred Brand 50% co-
insurance Mail Order: ◦ 15%, 25%, 45%
Out of Pocket Maximums $1300 per person and $2600 per family. • No Change for 2012
Deductible $1,300 EE$2,600 family* In network
Health Savings Account
$650 EE$1,300 family
Co Insurance
20% in network
50% out of network
Out of Pocket Maximum
$3,300 EE$6,600 family* In network
• Premium increase 10%
• Prescription Plan coverage through Medco
Under 44,000
Difference Over 44,000
Difference
Employee Only $171 $16 ($<1/wk)
$567 $52 ($1/wk)
Employee & Children
$308 $28 ($<1/wk) $908 $83 ($1.5/wk)
Employee & Spouse
$407 $37 ($<1/wk) $1419 $129 ($2.5/wk)
Family $512 $47 ($<1/wk) $1700 $155 ($3/wk)
New Flex Spending Account Administrator Dental Premiums Slight Increase Implement $250 additional premium◦Additional Premium for tobacco users, each for
employee and/or spouse/SSDP◦Everyone MUST go through open enrollment and
certify tobacco user status. If you do not, you will default to tobacco user and you will be assessed the additional premium along with any spouse/SSDP covered on your medical plan!!! Also, if you carry Add’l Term Life Insurance you will be assessed the tobacco user premium!
E-Benefits Certification I have not used tobacco products in the
past 12 months. I have used tobacco products in the past
12 months, but I have completed an approved tobacco cessation program between Sept. 1- Nov. 23, 2011 to qualify for a waiver of the additional premium for tobacco users.
I have used tobacco products in the past 12 months.
Open Enrollment Guide
Choose Well, Live Well News
Schedule of Activities◦ Voluntary Benefit Fair (10/26)◦ CIGNA medical plan (10/27 and 11/4)◦ Flexible Spending with PayFlex (11/7)◦ Walk In Enrollment Help Sessions
Websites◦ www://purdue.edu/benefits/◦ https://mycigna.com◦ http://www.purduecal.edu/hr
Call Human Resources at x2251
www.purdue.edu/benefits
Do too many factors and figures get confusing?
Maybe some sample employee stories would help.
www.purdue.edu/benefits
Reminders for Enrollment
Tobacco User Status Certification
October 24 – November 24, 2011
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