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Annual Enrollment for 2012 Plan Year

Northern Kentucky UniversityNorthern Kentucky University

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Talking Points

Are you buying the right amount of coverage for you and your family?

Just because it costs more than other options, does not mean that it’s the best choice for you

There are several changes to the plan options this year - options that might be better for you and your family

New…Northern Kentucky HMO-Total Care Plan

Going away…90/60 and the Coverage First plans

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2012 Annual Enrollment

Questions to Ask Yourself at Open EnrollmentHow does your family use healthcare services?How much do you spend on your benefits each paycheck?How much do you pay out of your own pocket?Would you rather pay less toward the premium and more when you receive care – or vice versa?

Up-Front Costs Paycheck contributions

Pay-as-you-go Costs Co-payments Deductible Coinsurance Out of Pocket Maximum

Once you know the answers, decide by: Comparing the available plans Using the online tools for guidance Choosing the plan that meets your healthcare needs and budget

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Preventive Services

Covered Services at 100% on all plans

– Routine Immunizations (to age 18)– Routine Pap smear– Annual routine mammogram– Routine lab and X-ray– Preventive endoscopy (colonoscopy)– Routine adult physical– Routine child exams (to age 18)

Please ensure your provider knows you are there for a preventive visit

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New - Your Northern KY HMO Plan

To learn more about HMOs, visit this Website:

StaySmartStayHealthy.com

Health Maintenance Organization (HMO) plan:

Lower, more predictable costs

Better care coordination using a Primary Care Physician (PCP)

Tighter network with access only to in-network providers in the NKY HMO – Total Care Plan

St. Elizabeth Healthcare System based network

Copayment and deductible driven plan option unique to Humana

PCP selection and referrals are required on this plan

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Northern KY HMO – Total Care Plan

What is the Total Care Plan?

– A new plan offering from Humana – an HMO built around the St. Elizabeth Healthcare and affiliated providers system

– Coverage is for in-network providers only, except in an emergency or specialty care*

* Out of network specialty care must be pre-approved prior to treatment

– You select a Primary Care Physician (PCP) who oversees and coordinates your health care needs

– Your PCP will refer you to specialists and other in-network providers*

* OBGYN and GYN do not need a referral

* Family Planning is covered on this plan by specific providers

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Northern KY HMO – Total Care Plan

Why would this plan be a good option for me?

– Cost effectiveness: lower premiums but still have copayment and deductible structured plan

– Comfort: you work directly with your selected in network PCP for your care

– St. Elizabeth Healthcare system: you and your family may already be using providers in the network** Cincinnati Children’s Hospital included in network

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Northern KY HMO – Total Care Plan

How to select your in-network Primary Care Physician (PCP)

– You will use the Humana.com search tool, “Find a Doctor” and “Physician Finder Plus” to search and choose your provider

– Remember, your network is NKY HMO -Total Care Plan

– Also, you will want to write down the PCP ID #. The PCP that you choose will appear on your new medical id card

* Instructions on how to search for a provider will be included with your enrollment materials

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Northern KY HMO – Total Care Plan

Once I select a PCP, now what?

– Your PCP selection will appear on your id card

– You can change your PCP as often as you like through Humana Customer Service or MyHumana.com

– Each family member can choose their own PCP

(ex. internist, pediatrician)

– PCP changes will be effective the 1st of the following month

– If one is not selected, then one will be initially chosen based on your zip code…you can then update or change to your preference

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Copayments (In Network) (Out-of-Network)

2012 Medical Plan Options – NKY HMO

In-Network Only

Physician 100% after $25 copay

Specialist 100% after $55 copay

Urgent Care 100% after $75 copay

Emergency Room 100% after $250 copay

Outpatient Non-Surgical 80% after deductible

Outpatient Surgery 80% after deductible

Inpatient Hospital 80% after deductible

Annual Deductibles $2,000 ind/ $4,000 fam

Out-of-Pocket (coinsurance & medical copayments)

$2,500 ind/ $5,000 fam

Rx4 Copays

(mail order is 2.5x)

$10/$35/$55/25%

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Your POS Plan

Flexibility to choose your doctors, hospitals, and other healthcare providers

Potential higher “upfront” premium, lower “pay as you go” cost

To learn more about POS, visit this Website:

StaySmartStayHealthy.com

Point of Service (POS) plan: Comprehensive coverage Caps on out-of-pocket

spending in a plan year Lower costs when you use in-

network providers

Benefits of a POS :

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Copayments (In Network) (Out-of-Network)

2012 Medical Plan Options - NPOS 80/50

In-Network Out-of-Network

Physician 100% after $25 copay 50% after deductible

Specialist 100% after $40 copay 50% after deductible

Urgent Care 100% after $40 copay 50% after deductible

Emergency Room 100% after $200 copay 100% after $200 copay

Outpatient Non-Surgical 80% after deductible 50% after deductible

Outpatient Surgery 80% after deductible 50% after deductible

Inpatient Hospital 80% after deductible 50% after deductible

Annual Deductibles $750 ind/ $1,500 fam $2,250 ind/ $4,500 fam

Out-of-Pocket

(coinsurance only)

$3,000 ind/ $6,000 fam $9,000 ind/ $18,000 fam

Rx4 Copays

(mail order is 2.5x)

$10/$35/$55/25% 70% after copay

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Rx4: 4-tiered benefit design

Tier 1: Low-cost generic and some brand-name drugs

Tier 2: Higher-cost generic and brand-name drugs

Tier 3: Higher-cost drugs – usually have generic or brand-name alternatives in Tiers 1 and 2

99 percent of all Humana’s prescription drugs are in Tiers 1–3

Tier 4: Self-administered injectables and high-technology drugs that are often newly approved by FDA – doesn’t include insulin

Tier 1

$10Ex: Naproxen

Tier 2

$35Ex: Omrepizole

Tier 3

$55Ex: Lipitor

Tier 4

25%*Max $2500

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Accuracy and safety Convenient home delivery by mail Integrated service 2.5X for HMO and NPOS plans 3X for HDHP plan

Ordering New Prescriptions Get a new prescription from your doctor for

a 90 day or 3 month supply Submit your order and payment Check your mailbox

Mail-order pharmacy advantages

StaySmartStayHealthy.com

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Your High Deductible Health Plan (HDHP)

No copayment for office visits or prescriptions

All covered medical and prescription expenses go toward the same integrated deductible

Plan covers expenses at the coinsurance level after deductible:

• 100 percent in-network• 70 percent out-of-network

Components of the HDHP

Security and peace of mind by limiting Maximum Out-of-pocket

• Preventive Services covered at 100 percent

• Upfront deductible

• Member may use Health Savings Account to cover the member cost-share

To learn more about the HDHP, visit this Website:

StaySmartStayHealthy.com

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Copayments (In Network) (Out-of-Network)

2012 Medical Plan Options - HDHP

In-Network Out-of-Network

Physician 100% after deductible 70% after deductible

Specialist 100% after deductible 70% after deductible

Urgent Care 100% after deductible 70% after deductible

Emergency Room 100% after deductible 100% after deductible

Outpatient Non-Surgical 100% after deductible 70% after deductible

Outpatient Surgery 100% after deductible 70% after deductible

Inpatient Hospital 100% after deductible 70% after deductible

Annual Deductibles $3,000 ind/ $6,000 fam $6,000 ind/ $12,000 fam

Out-of-Pocket 100% once deductible is met $10,000 ind/ $20,000 fam

Rx Benefit

(mail order is 3x)

100% after deductible 70% after deductible

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What’s a Health Savings Account (HSA)?

A Health Savings Account (HSA) is a tax-free bank account that helps you:

– Budget for health care expenses this year

– Build savings for the future

You must be enrolled in a High Deductible Health Plan to contribute to an HSA

You don’t pay federal taxes on money in your HSA if used for qualified expenses

HSA interest and investment earnings are tax-free

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Financial Features of an HSA

Important Features of a (HSA)

Maximum 2012 Contributions $3,100 single/$6,250 family

NKU Contributions – Annual Amount$750 single/$1,500 family

Contribution Strategy2012- Per pay period

Catch-Up Contributions$1000 for 55 and older

Use funds to pay for medical, prescription, dental, and vision expenses

To learn more about the HSA, visit this Website:StaySmartStayHealthy.com

Tax Advantages of a Health Savings Account … Easy as 1, 2, 3

Member controls how to save or spend money

Contributions are tax-free

Withdrawals are tax-free

Interest is earned tax-free

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Humana’s Health Savings Account

Three simple ways to access your HSA funds

1. HumanaAccessTM Visa Debit Card

2. Interactive voice response (IVR) toll-free number

3. Online at MyHumana.com

HSA funds are limited to qualified medical expenses. For a full list of qualified expenses, visit www.irs.gov.

HumanaAccess Card

Spending decisions are nowin your hands

Convenient, accurate access to healthcare funds that:

Help you stay on top of your healthcare spending decisions

Provide immediate, secure access to healthcare funds

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Other Helpful ResourcesHumanaFirst® Nurse Advice Line: 24-hour toll-free health information line

Automated Information Line: Quick and easy way to get answers to general

Questions – call Humana Customer Care at 1-800-4-HUMANA

Personal Nurse®: One-on-one guidance for members who we believe may benefit from additional support

Humana Beginnings®: Helps members learn more about their pregnancy, follow their baby’s development, and practice healthy habits along the way

PlanProfessorSM: A free publication for members

Disease management programs: Help manage chronic or severe conditions

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Coverage that’s just right for you!

Humana’s online tools help you:

Compare plans based on expected use • Estimate costs for procedures

• Estimate healthcare costs

Find possible cost-saving alternatives to medications • Rx Calculator

How to access the comparison tools at Humana.com:• Go to Humana.com and select the tab “Insurance through Employer”

• Locate the title “Enrollment Center” and select the link “Enroll Online”

• Select the “Enroll Now” option

• Choose how you would like to log in – as a Non-Registered User or a Registered User

• Follow the prompts through out

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Benefits Planner Tools: Closest to My Current Plan

Closest to My Current Plan

visually indicates which plan is most similar to user’s current plan

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Use the calculator to estimate how you and your covered dependents might use healthcare services in the upcoming year

• Primary Care Physician• Specialist• Outpatient Surgeries• Hospital Admissions• Prescriptions filled

Benefits Planner Tools: My Estimated Expenses

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Benefits Planner Tools: My Estimated Expenses

My Estimated Expenses:

results for each plan are displayed

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Points to Remember!

When? Meetings: Dates and Times available on HR website1 on 1 Sessions: Information available on HR website

Where? Refer to annual enrollment bulletin from HR and HR website

How? http://myNKU.edu, Employee Self-Service Open Enrollment

Need Help? Enrollment Help Center on Campus: October 6 through October 21 in Steely Library room 235

Humana Online Comparison: website opens 9/19/11 Humana Enrollment Hotline: 1-888-393-6765

All employees must enroll for 1/1/2012 coverage by October 21 deadline If you do not enroll, you will NOT have coverage Remember to show your I.D. card to all of your providers beginning 1/1/2012.

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