2010 Open Enrollment Update & UPlan Changes For Calendar Year 2011

2010 Open Enrollment Update & UPlan Changes

For Calendar Year 2011

What’s in this presentation?

What’s New for 2011 Open Enrollment Basics UPlan Pharmacy Program Changes Flexible Spending Accounts 2011 UPlan Rate Information UPlan Life Insurance Changes and Rates Wellness Program Highlights for 2011 Other UPlan Information Open Enrollment Resources 2011 Plan Rates (charts)

What’s New for Open Enrollment 2010?

New Pharmacy Benefit Manager – Prime Therapeutics LLC

Changes in eligible expenses for reimbursement in the Health Care FSA

Increase in Dental benefits annual per person maximum from $1,500 to $1,800

Increase in Life Insurance Rates for optional life insurance

Online scheduling for flu shots at campus clinics and at the Employee Health & Benefit Fairs:

www.bhs.umn.edu/public-health/flu.htm

What’s new for the 2010 Open Enrollment?

http://www.bhs.umn.edu/publice-health/flu.htm

2010 Open Enrollment Basics for January 1,

2011

What is Open Enrollment?

Your annual opportunity to review your benefit elections: November 1–30, 2010

Employees make changes online at: http://hrss.umn.edu/

Additional information on Employee Benefits Website at: www.umn.edu/ohr/benefits/openenroll

http://hrss.umn.edu/

http://www.umn.edu/ohr/benefits/openenroll

What benefits can I change?

Add or cancel Medical or elect a different plan option

Add or cancel Dental or elect a different plan option

Add, change, or cancel your dependents

Elect to participate in the Health Care or Dependent Daycare Flexible Spending Accounts

What other benefits can I change?

Elect to participate in Voluntary Long-term Disability coverage (Civil Service and Represented Staff employees), or

Increase or decrease your Long-term Disability benefit amount

What if I do not want to change anything this year? You do not need to go online and

change your elections Unless you are an FSA participant and

want to have an account for 2011 To change your clinic election, call your

health plan directly

2010 is a voluntary Open Enrollment – no changes required

Who can I cover on my UPlan Medical & Dental

Plans? Yourself Your spouse or registered same-sex

domestic partner Your dependent child or children to

age 26 Unmarried or married But not the spouse of a married child

Click below to review detailed Dependent Eligibility Definition

www.umn.edu/ohr/benefits/eligibility/index.html

http://www.umn.edu/ohr/benefits/eligibility/index.html

http://www.umn.edu/ohr/benefits/eligibility/index.html

Will we receive Open Enrollment booklets this year? Open Enrollment booklets will be online Open Enrollment details will be covered in

a newsletter in late October, mailed to campus address

A limited number of booklets will be sent to: Employees who do not regularly use a

computer for their jobs Employees who are on a leave of absence Early Retirees Former employees on COBRA Former employees on separation agreements

Will I get new cards for 1/1/2011? You will receive a new pharmacy card from

Prime Therapeutics that will replace your RxAmerica/CVS Caremark card. Bring it to the pharmacy for prescriptions on or after 1/1/2011

You will receive a new card if you enroll in a new plan

Medica, HealthPartners medical plan, and Delta Dental will issue new cards

HealthPartners dental plans will not issue new cards

Will flu shots be available this year?

Seasonal Flu Shots will be available this year

Flu shots will be available at campus flu clinics and the Employee Health & Benefits Fairs

Seasonal Flu shots available at MinuteClinic

No copay for flu shots at your own medical clinic

Flu shots at retail locations are full price and will likely not be billed to your medical plan

On the Twin Cities campus: schedule appointment for flu shot online at: www.bhs.umn.edu/public-health/flu.htm

http://www.bhs.umn.edu/public-health/flu.htm

2011 ChangesUPlan Pharmacy

Program

What are the pharmacy changes for 2011?

Prime Therapeutics LLC, will be the new Pharmacy Benefit Manager (PBM) on January 1, 2011 Replaces CVS Caremark (formerly

RxAmerica) New cards will be mailed in December

with information regarding Specialty Medications and Mail Order Service, MTM

Working to transfer all CVS Caremark Mail Order prescriptions (with open refills) and Prior Authorizations to Prime Therapeutics

Who is Prime Therapeutics LLC?

New Pharmacy Benefit Manager chosen in a scheduled Request for Proposal (RFP) process

Headquartered in Eagan, Minnesota Broad Minnesota and National pharmacy

network Network of 60,000 pharmacies that include

Walgreens, Target, Walmart, CVS, other chains and many small retail pharmacies.

Includes HealthPartners pharmacies Mail order facility in Irving, Texas

Will there be changes for Specialty Medications?

Fairview Specialty Pharmacy will become the exclusive provider of most specialty medications

They offer convenient delivery of medications and additional support for members

Members in the Twin Cities will be able to use any Fairview pharmacy in the network, as well as the home specialty delivery

Statewide, Fairview will ship medications and in Duluth, St. Mary’s and St. Luke’s pharmacies will participate

What is a Specialty Medication?

Prescribed for complex or ongoing medical conditions

Usually are injected or infused Have unique storage or shipment

requirements Need education or additional support by a

healthcare professional Often not stocked at retail pharmacies

Are there any changes in pharmacy copays for

2011?2010 – 2011

Copays (No Changes)

Generic Plus $8

Brand Formulary $25

Non-Formulary $50

Not Covered Full Cost

Am I eligible for the Medication Therapy

Management Program? Medication Therapy Management

Members with four or more medications for chronic conditions

UPlan-paid consultations with MTM Pharmacist

$8 copay reductions for all Generic Plus and Brand medications for six months

HSA members pay full cost of MTM consultations

www.umn.edu/ohr/benefits/

http://www.umn.edu/ohr/benefits/disability/shortterm

How do I contact Prime Therapeutics and

Fairview Specialty Pharmacy? Prime Therapeutics Customer

Service: 1-800-727-6181

Fairview Specialty Pharmacy Customer Service: 1-877-509-5115 and 612-672-5289

Flexible Spending Accounts

What are Flexible Spending Accounts?

The UPlan includes: Health Care Flexible Spending Account Dependent Daycare Flexible Spending

Account Your contributions to both accounts

are made with pre-tax dollars No Federal, state, or Social Security

taxes are taken No FSA Enrollment = No FSA for 2011

How much can I contribute to a Flexible Spending Account?

Health Care FSA Minimum: $100 Maximum: $5,000

Dependent Daycare FSA $5,000 maximum per family

www.umn.edu/ohr/benefits/openenroll



What else do I need to know about Flexible Spending Accounts for

2011? 2011 contributions are made during

the calendar year 2011 claims can be incurred between

January 1, 2011, and March 15, 2012 “Use it or lose it”

Any amount remaining after March 15, 2012, is forfeited

Note: 2010 claims can be incurred through March 15, 2011

Are there any changes for Flexible Spending Accounts for 2011?

Section 9003 of the Affordable Care Act established a new uniform definition of qualified medical expenses effective on January 1, 2011

Reimbursement will be made only if the medicine or drug (1) requires a prescription, (2) is available over the counter (OTC) and individual obtains prescription, or (3) is insulin

New rule affects purchases made in the 2½ month grace period (1/1 to 3/15/11): must have a prescription for OTC medication beginning 1/1/11

Note: Insulin does not require a prescription

Are there any other changes for Flexible Spending Accounts for

2011? New rule does not affect reimbursement

for OTC supplies and devices, such as contact lenses and lens cleaning solutions, eyeglasses, prescription and office copays, bandages, blood sugar test kits, and out-of-pocket dental charges

Be conservative in estimating your health care account contributions for 2011: do not include amounts for OTC medications unless you will have a prescription from your physician

UPlan Rates for 2011

How are rates determined for UPlan Medical

options? UPlan: self-insured program Actuarial consultant: helps set rates Costs reflect actual cost of care: for

employees, early retirees, and dependents

Costs include: Medical and pharmacy claims, external administrative fees, special insurance for high claims, internal costs, MEDEX, wellness program

How is the Base Plan the Key to Employee

Cost? For Medical, employees pay: 10% of Base Plan for Employee Only 15% of Base Plan for Family Coverage Everything above the U’s Base Plan rate

contribution for “buy-up” (higher cost) plans

Costs vary by Employee/Family tier Rate Information:

Next section of this presentation. U & Your Benefits Newsletter — October

2010

What are the employee Medical rate changes for

2011? Medical Rates

Increase is 7.5 percent Same percent increase applies to all

plans

2011 Medical Plan Options

Are the same Medical Plans available in 2011?

All Medical plans remain the same: Medica Elect & Essential – Twin Cities &

Duluth (Base Plan in Twin Cities and Duluth)

Medica Choice Regional – Greater Minnesota(Base Plan for Greater MN)

U Classic Plus by HealthPartners Insights by Medica (tiered network) Medica Choice National (open network) Medica Health Savings Account (HSA)

Plan

2011 Dental Plan Options

Are the same Dental Plans available in 2011?

All Dental options remain the same for 2011

The base plan choices are: Delta Dental PPO for the Twin Cities and

Duluth Delta Dental Premier for Greater

Minnesota

www.umn.edu/ohr/benefits/openenroll



What other Dental Plan options are available in

2011? All other plans also remain the same:

Delta Dental Premier HealthPartners Dental HealthPartners Dental Choice University Choice Check with Delta Dental or

HealthPartners to see whether your dentist is in the plan you are considering

What are the employee Dental rate changes for

2011? Dental Rates

There is an increase of 3.4% due to an increase in the out of pocket maximum. In 2011, the annual maximum benefit will increase from $1,500 to $1,800

Same % increase applies to all plans

UPlan Life Insurance Changes and Rates Effective January 1, 2011

Are there changes to the UPlan Life Insurance Rates? Rates for Additional Employee and

Spouse/Same Sex Domestic Partner Insurance will increase by 10% in most age divisions on January 1, 2011

New rates are based on the claims experience of the University program

Rates are guaranteed for three years

Wellness ProgramOptions for 2011

What Wellness Programs will continue in 2011?

Wellness Assessment: January through April 2011

Health Improvement Programs Phone-based Health Coaching In-person Health Coaching – Twin Cities,

Duluth, and Morris Online Healthy Living Programs and 10,000

Steps® walking program $65 Reward for Employee & Spouse/SSDP

Fitness Rewards Program $20 monthly subsidy for health club

participants Farmers Market: Minneapolis and Duluth

Are the Weight Management Programs offered again in

2011? Weight Management Programs for 2011 Create your Weight — offered through Fairview on

Twin Cities Campus Weight Watchers at Work — offered on The Twin

Cities and coordinate campuses with at least 20 participants enrolled

You pay up front: Wellness Program will reimburse you in full if you attend 80% of sessions (Costs: $180 to $200)

You can be reimbursed for up to three sessions per year; six total lifetime reimbursements

HIP (Health Improvement Program) available at UMD at no cost-Weight Management Focused Program

Details available at: www.wellness.umn.edu

http://www.wellness.umn.edu/

Would you like to be a Wellness Advocate for your

Department?Wellness Advocates Program:

Looking for Wellness Advocate from each College, Department

Lead departmental Wellness initiatives Wellness Program to provide support,

materials, and training Plus special programs for wellness

advocates Interested? Email to [email protected]

mailto:[email protected]

Disability Coverage

Who can enroll in Long-term Disability during Open

Enrollment? Civil Service and Represented Staff

Employees May enroll in or change the amount of

Long-term Disability during Open Enrollment.

Maximum Benefit: 60% of salary up to $5,000 per month.

Pre-existing Condition Limit: Disabilities related to medical issues during past 12 months will not be covered for 24 months.www.umn.edu/ohr/benefits/openenroll


When can I enroll in Short-term Disability?

You can enroll or increase your Short-term Disability at any time during the year

New Short-term Disability enrollments or increases will require proof of good health

See Website for details on how to apply

www.umn.edu/ohr/benefits/disability/shortterm



Additional Items for Open Enrollment

What else do I need to know about the UPlan for

this year? Open Enrollment – November

2010 Social Security Numbers

Required for UPlan Members ages 45 & up

CMS / Medicare Requirement Potential denial of claims if SSN is not

provided Contact the Employee Benefits Service

Center for more information.

Enrolling Online If hired before December 1, new employees

may make two elections to participate in FSA for 2010 and 2011

Multiple elections can be made online but not at the same time; wait a day between enrollments

Benefits will send an e-mail to affected employees

Employees with appointments ending prior to January 1, 2011, cannot enroll online — they are not anticipated to be active employees in 2011

Open Enrollment Communications

Employees with registered same-sex domestic partners will receive a letter and instructions for Open Enrollment. Elections can be made online, if registered, or on paper

Materials are sent to employees on leave of absence & to those with no computer access

An e-mail will be sent on November 1 to announce the start of open enrollment

A final reminder e-mail will be sent near the end of November

Open Enrollment Communications

One set of medical & dental directories sent to each department Contact Mo Perry @ [email protected]

to request more for additional locations Employee Health & Benefits Fair

poster sent to department

Note: also contact Mo Perry to update the DEBCP e-mail list


Benefits Materials for 2011 U & Your Benefits newsletters Guide for UPlan Benefits Enrollment

(print copy for new employees and available online)

COBRA instructions and rates Benefits Summaries for prospective

employees Summary of Benefits for Medical Plans Summary of Benefits for Dental Plans Check the Manager’s Toolkit on OHR Web

sitehttp://www.umn.edu/ohr/debcp/index.html

When are the Employee Health & Benefits

Fairs? Minneapolis: November 2: Coffman

Memorial Union – Great Hall – 10 a.m. to 4:30 p.m.

St. Paul: November 3: St. Paul Student Center – North Star Ballroom – 10 a.m. to 4:30 p.m.

Duluth: November 4: Kirby Student Center – Ballroom – 10 a.m. to 3 p.m.

Morris: November 11: Oyate Hall, UMM Student Center – 11 a.m. to 1 p.m.

Open Enrollment Resources

What if I need help with enrollment?

Telephone: 612-624-9090 or 1-800-756-2363 Option 2 ̶ General benefits questions Option 3 ̶ FSA questions

E-mail: [email protected] Benefit Fairs: Computer help and Employee

Benefits staff available to answer questions Computer Labs (Twin Cities): Room 315

Donhowe Bldg. November 17: 7 a.m. to 7 p.m. November 24, 29, and 30: 8 a.m. to 4:30 p.m.


What if I want to talk to Employee Benefits?

Employee Benefits Service Center612-624-9090 or 1-800-756-2363 Option 2 ̶ General benefits questions Option 3 ̶ FSA questionsTelephone Language Interpretation service available through Employee Benefits

Employee Benefits Websitewww.umn.edu/ohr/benefits/openenroll



What if I want to talk to the Health Plans?

Delta Dental: 651-406-5916 or 1-800-448-3815

Fairview Specialty Pharmacy: 1-877-509-5115 and 612-672-5289

HealthPartners: 952-883-5000 or 1-800-883-2177

Medica: 952-992-1814 or 1-877-252-5558

Prime Therapeutics: 1-800-727-6181

Rates for Plan Year 2011

2011 Medical Rates – Employee Only

Plan2011 Biweekly Rates

Total University Employee

Medica Elect & Essential – Twin Cities

$ 253.60 $ 228.20 $ 25.40

Medica Elect & Essential – Duluth

$ 272.30 $ 246.90 $ 25.40

Medica Choice Regional – Greater Minnesota

$ 318.10 $ 292.70 $ 25.40

U Classic Plus by HealthPartners

$ 264.20 $ 228.20 $ 36.00

Insights by Medica $ 271.80 $ 228.20 $ 43.60Medica Choice National $ 274.70 $ 228.20 $ 46.50Medica HSA $ 253.90 $ 228.20 $ 25.70

2011 Medical Rates – Employee and Spouse or Same-Sex

Domestic PartnerPlan

2011 Biweekly RatesTotal University Employee


$543.70 $ 462.10 $ 81.60


$ 584.00 $ 502.40 $ 81.60


$ 681.90 $ 600.30 $ 81.60


$ 568.10 $ 462.10 $ 106.00


2011 Medical Rates – Employee and Child/Children




$ 440.30 $ 374.30 $ 66.00

Medica Elect & Essential Duluth

$ 473.00 $ 407.00 $ 66.00


$ 552.10 $ 486.10 $ 66.00


$ 458.50 $ 374.30 $ 84.20

Insights by Medica $ 471.70 $ 374.30 $ 97.40Medica Choice National $ 476.70 $ 374.30 $ 102.40

Medica HSA $ 441.30 $ 374.30 $ 67.00

2011 Medical Rates – Employee and Spouse/SSDP and

Child/ChildrenPlan

2011 Biweekly RatesTotal University Employee


$ 728.90 $ 619.60 $ 109.30


$ 783.90 $ 674.60 $ 109.30


$ 915.10 $ 805.80 $ 109.30


$ 757.70 $ 619.60 $ 138.10


2011 Dental Rates – Employee Only



Delta Dental PPO – Twin Cities and Duluth

$ 15.75 $ 14.15 $ 1.60

Delta Dental Premier – Greater Minnesota

$ 18.75 $ 17.15 $ 1.60

University Choice $ 21.20 $ 14.15 $ 7.05Delta Dental Premier $ 18.75 $ 14.15 $ 4.60HealthPartners Dental $ 17.20 $ 14.15 $ 3.05HealthPartners Dental Choice

$ 18.50 $ 14.15 $ 4.35

2011 Dental Rates – Employee and Spouse or Same-Sex Domestic

Partner




$ 33.45 $ 20.05 $ 13.40


$ 39.50 $ 26.10 $ 13.40


$ 39.45 $ 20.05 $ 19.40

2011 Dental Rates – Employee and Child/Children




$ 38.15 $ 22.90 $ 15.25


$ 45.20 $ 29.95 $ 15.25


$ 45.75 $ 22.90 $ 22.85

2011 Rates for Additional Employee and Spouse/SSDP Life Insurance

Age Per $5,000 per Biweekly pay periodUnder 30 $ 0.09

30-34 $ 0.1135-39 $ 0.1340-44 $ 0.1545-49 $ 0.2450-54 $ 0.4055-59 $ 0.6260-64 $ 1.0065-69 $ 1.6070-74 $ 2.5775-79 $ 4.1280-84 $ 6.6685+ $ 13.29

2011 Dental Rates – Employee and Spouse/SSDP and Child/Children




$ 53.40 $ 32.05 $ 21.35


$ 63.40 $ 42.05 $ 21.35


$ 62.60 $ 32.05 $ 30.55

Thank you for attending and for helping

employees

2010 Open Enrollment Update & UPlan Changes For Calendar Year 2011

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