Benefits for 2013

D A AR

Benefits for 2013

D A A R

KNOWLEDGE

LEADERSHIP

EXPERIENCE

QUALITY

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Thank you all for your feedback!

Actual cost to DAAR to provide medical coverage....

Over $8,000 per person insured per year for Medical insurance only

SURVEY

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Premium: Monthly fee to have a plan.Deductible: Amount that needs to be paid BEFORE benefits kick in.Provider: A doctor or facility.In-Network: Using a United Healthcare provider.Out of Network: Using a doctor that is not contracted with United Healthcare.Out of Pocket Maximum: Maximum total that a member or family would have to pay

for a year on a plan after premium. *one for IN and one for OUT of network.Coinsurance: Amount that United Covers once you have reached your deductible,

but BEFORE you reach the applicable out of pocket maximum.HRA: Health REIMBURSEMENT Account – Money from DAAR to help you pay your

billsHSA: Health SAVINGS Account – Bank account in your name that you can use to pay

for medical, dental, vision and future medical related expenses. You can deposit PRE-tax money and DAAR can deposit money.

Contribution: Money given by DAAR or money that you choose to add to your HSA.MFSA: Medical Flexible Spending Account – money that you can have deducted over

the course of the year PRE-tax to pay for medical, dental and vision expenses. Total yearly amount is available January 1st. Any money not used is lost at the end of the year.

LPFSA: Limited Purpose FSA – same as MFSA but limited to dental and vision only. DCFSA: Dependent Care FSA – pre-tax contributions are made for childcare

reimbursement. Available as contributions are made .HIPAA: Health Insurance Portability and Accountability Act

MEDICAL – DEFINITIONS

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1. Payment shift from POST-Tax deductible to PRE-Tax payroll premium contribution.

2. You now have 2 plans to choose from. – One geared for out of network protection (HRA)

• In-Network provider limitation, kids in college in other areas, frequent travelers.

– One geared for flexibility and self management (HSA)• Savings option, rollover contributions, multi-use (medical, dental, vision,

future)3. The amount of DAAR’s contribution is equal to the

amount of your in-network deductible on both plans.

MEDICAL – MAJOR CHANGES

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HRA Plan

Employee: $528 per year PRE-tax$396 post-tax*$15 net effect per

pay*EE + Child(ren): $1,111 per year

PRE-tax$833 post-tax*$32 net effect per

pay*EE + Spouse: $1,222 per year PRE-tax

$916 post-tax*$35 net effect per

pay*Family: $1,336 per year

PRE-tax$1,002 post-tax*$38 net effect per

pay*

MEDICAL – PREMIUM RATESHSA Plan

Employee: $475 per year PRE-tax$356 post-tax*$13 net effect per

pay*EE + Child(ren): $1,000 per year


pay*EE + Spouse: $1,100 per year PRE-tax

$825 post-tax*$31 net effect per

pay*Family: $1,200 per year


pay**assumes a 25% tax basis. May be slightly higher or lower due to tax status.*bi-weekly post-tax impact estimate

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Current Plan Plan A Plan BPlan Structure HRA HRA H.S.A.Deductible structure Embedded Non-Embedded Non-Embedded$ from DAAR 1025/2000 1500/3000 1250/2500In-Network Deductible 1500/3000 1500/3000

1250/2500CoInsurance - IN 100% 100% 100%OOP Max 1500/3000 1500/3000 1250/2500Out of Network Deductible 3000/6000 1500/3000 2500/5000CoInsurance - OUT 70% 80% 70%OOP Max 10000/20000 4000/8000 10000/20000Ded applies to OOP Max NO YES YESGap Exceptions Allowed NO? YES YESAdditional Savings Option NO NO YES-up to 6,450 famMed, Dent & Vis Expenses Incl. NO NO YESLPFSA YES YES YESFirst Dollar HRA/H.S.A. NO YES YES

Ex: 10,000 fam med bills OUT PLAN A PLAN B 3000HRA from DAAR (first dollar) 2500 H.S.A. from DAAR (first dollar)140020% of remaining 7,000 2500 Family rem out of network ded1336Premium pre-tax 1200 Premium pre-tax2736Family Total 1500 30% of remaining 5,000

5200 Family Total

Ex: 10,000 fam med bills IN PLAN A PLAN B 3000HRA from DAAR (first dollar) 2500 H.S.A. from DAAR (first dollar)

1336Family Total: Premium pre-tax 1200

Family Total: Premium pre-tax

MEDICAL

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HSA BENEFIT SUMMARY

Full Summary Provided on the DAAR Intranet

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HRA BENEFIT SUMMARY


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Plan Benefits to Employee

• 1st Dollar HRA from DAAR• FULL coverage of in-network deductible by

HRA• Excellent In and Out of Network coverage:

Dr. choice, kids out of state, frequent travel• Simple structure: HRA covers 100% of in-

network deductible: Eliminates need for medical FSA & complications with HRA

• LP FSA for Dental & Vision PRE-tax Saving• PRE-tax premium payroll deductions• Your first dollar spent for out of network

expenses after deductible is only 20% (was 30%)

• Deductible money applies toward OOP Maximums

• HSA Contribution from DAAR available day 1• HSA Contribution is equal to FULL coverage

of in-network deductible• Contribution goes into a personal HSA bank

account and cannot be taken back. Full amount is for employee use once given.

• Recommended for In-network use• More choice through self-management• Flexibility - HSA can be used for medical,

dental, vision and future• Rollover• Can invest• Can add additional savings PRE-tax• PRE-tax premium payroll deductions• Tax deduction in year that you use any

amounts you deposit (not on DAAR contribution)

Plan A - HRA Plan B – HSA

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1/1/13 In-Network Doctor Visit: Tests $1500 Pay $0 – DAAR HRA

will pay

2/5/13 In-Network Doctor Visit: Tests $2000 Pay $0 – DAAR HRA

will pay $1500 then 100% of all in-network bills are covered.

Total OOP = $0

MEDICAL – HRA EXAMPLE 1

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1/1/13 Dental Visit: Crown $800 Pay $800 with personal money or

LPFSA card

1/5/13 In-Network Doctor Visit: Tests $3500Pay $0 – DAAR HRA

will pay $3000 then 100% of all in-network bills are covered.

Total OOP = $800


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1/15/13 Prescription: $1000 Pay $1000 with personal money. HRA will send you a reimbursement check for $1000 in a few weeks.

2/15/13 In-Network Doctor Visit: $2500 Pay $0 – HRA will pay $2000 then insurance will cover in-network at 100%.

Total OOP = $1000 but get reimbursed


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1/1/13 Out of Network Dr. Visit: $3000 Pay $0 – DAAR HRA will pay.

1/15/13 In-Network Dr. Visit: $3000 Pay $3000 with personal money.

2/15/13 In-Network Dr. Visit: $1000 Pay $0 – coinsurance will pay 100% of all remaining in-network bills.

3/15/13 Out of Network Doctor Visit: $2000 Pay $400 with personal money – coinsurance will pay remaining 80%.

4/15/13 Out of Network Hospital Visit: $70,000 Pay $4600 (20% up to $8000 total oop max) – coinsurance will pay all remaining bills

(3000+400+4600 = $8000) ABSOLUTE family MAX OOP Using In and Out of Network Providers


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Employee chooses to contribute $0 into HSA over 2013

1/15/13 Doctor Visit: Tests $1500 Pay $1500 with HSA card

2/15/13 Doctor Visit: Tests $2000 Pay $1000 with HSA card-DAAR contrib. United will cover remaining $1000 and all future in-network medical.

Total OOP = $0

MEDICAL – HSA EXAMPLE 1

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1/15/13 Doctor Visit: Tests $1500 Pay $1500 with HSA card-DAAR

contrib.

2/15/13 Dental Visit: Crown $800 Pay $800 with HSA card-DAAR

contrib.

Total OOP = $0


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2/15/13 Dental Visit: Crown $800 Pay $800 with HSA card

4/15/13 Doctor Visit: Tests $400 Pay $200 with HSA card, pay $200 with personal money.

5/15/13 Doctor Visit: Tests $1000 Pay $600 with personal money then United covers 100% of in- network.

Total OOP = $800

MEDICAL – HSA EXAMPLE 3 – ASSUMES ALL IN NETWORK

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Employee chooses to contribute $2,000 into HSA over 2013(2,000/26 = 76.92 per bi-weekly pay (pretax))

1/10/13 Dental Visit: Crown $800 Pay $800 HSA card


3/1/13 Doctor Visit: Tests $2000 Pay $507.68 with HSA card ($200 DAAR contribution + $307.68 employee contribution – 4 weeks) Pay $492.32 with personal money. United will cover remaining $1000 and all future in-network medical.

As HSA is accumulated, it can be used for Medical, Dental, Vision, or saved for future use.

Total OOP = $492.32


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Employee things to consider…

• If Rx early in the year, you pay, then wait for 100% reimbursement check.

• HRA cannot be used for any expenses other than 2013 medical

• Can use a LPFSA for dental and vision, but if not used, it is lost at the end of the year

• Still important to consider your provider and cost information. The more expensive our claims are, the higher the rates become for future years.

• If DAAR HSA contribution is used for dental or vision, then employee pays for medical deductible when used if out of HSA $

• You pay the bills using your HSA card and other personal money

• If you have an existing FSA with more than a $0 balance on 12/31/12, the HSA deposit CANNOT be made until 4/1/13.

• HSA contribution will be made the first week of January. Will be able to use it for 1/1/13 bills.

• $1 fee per month if balance falls below $500• Will have the option of investing the money

to earn interest.• Still important to consider your provider and

cost information. The more expensive our claims are, the higher the rates become for future years.

Plan A - HRA Plan B – HSA

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Yearly coverage amount total $2,000 per person – not orthoOrtho up to 19yrs - $2000 per lifetimeDeductible: $25 (not applied to preventive or ortho)

In-Network CoveragePreventive 100% basic cleaning, sealants, x-rays

(frequency limitations)Basic 80% fillings (may cost extra for white fillings on back

teeth)Major 50% crowns, bridges, implants, periodontics, etc.

If you go out of network you will only have coverage up to the in-network amounts. Eg. If the in-network cleaning fee is $50, and you go out of network to a dentist that charges $70, you are responsible for $20 even though the Summary of Benefits says 100% out of network coverage (small print)

DENTAL BASICS

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DENTAL BENEFIT SUMMARY


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Employee: $43.78 per month$10.10 per pay (50%)*

EE + Spouse: $87.55 per month$20.20 per pay (50%)*

EE + Child(ren): $106.46 per month$24.57 per pay (50%)*

Family: $158.56 per month$36.59 per pay (50%)*

DENTAL – PREMIUM RATES – DAAR 50% CONTRIBUTION

*PRE-tax deduction

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Exam-100% covered-glasses or contacts once every 12 months

Frames - up to $130 once every 12 monthsStandard glasses lenses – 100% coveredContacts – 4 boxes of Covered-in-full selection (Elective)

OR $105 for non-covered selection (Elective) OR Covered in full if NECESSARY

www.myuhcvision.com to see benefits and print card

VISION-IN NETWORK

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VISION BENEFIT SUMMARY


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Employee: $12.72 per month$5.87 per pay (100%)*

EE + Spouse: $20.20 per month$9.32 per pay (100%)*

EE + Child(ren): $21.15 per month$9.76 per pay (100%)*

Family: $31.68 per month$14.62 per pay (100%)*

VISION – PREMIUM RATES

*PRE-tax deduction

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Will continue to be available for those who choose to enroll in their services.

Require HIPAA forms to be completed and submitted. Forms can be found on the DAAR Intranet.

1-866-253-2273

PATIENT CARE

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Will continue as 100% DAAR paid premium benefit for 2013 for all Full-Time employees.

Provided through Lincoln Financial Services.

https://www.lincoln4benefits.com/JPFebill/MemberEx/Registration/AutoReg_ssn_dob.asp

SHORT TERM DISABILITY

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Provider is Diversified Benefit Services

Limited Purpose FSAUsed for Dental and Vision expenses ONLY2013 Maximum contribution is $2,500Full amount of yearly contribution is available January 1, 2013

Dependent Care FSAUsed for pre-tax childcare savings2013 Maximum contribution is $5,000Available as contributions are made throughout the year

www.dbsbenefits.com

FLEXIBLE SPENDING ACCOUNT

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Lincoln • Life, AD&D, LTD

– Spouse and Child– Group rates– Evidence of Insurability requirements

AFLAC • Accident, Cancer, Life, AD&D, LTD

– Individual rates

www.lincoln4benefits.com

VOLUNTARY BENEFITS

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Provided by AscensusCan be changed at any time throughout the year.Initiate the change online. Melissa will be notified to update

deductions for payroll.Eligible after 3 months of employment regardless of status.Company match 50% of up to 8% of employee contribution. Vesting

schedule applies.

www.ascensus.comwww.planservices.com/ml

401K

Vesting Schedule:Less than 2 0%2 Years: 20%3 Years: 40%4 Years: 60%5 Years: 80%6 Years: 100%

http://www.ascensus.com/

http://www.planservices.com/ml

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WWW.MYUHC.COM - LOGIN

http://www.myuhc.com/

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WWW.MYUHC.COM – HOME PAGE


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WWW.MYUHC.COM – ACCOUNT BALANCES


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WWW.MYUHC.COM – CLAIMS SUMMARY


Benefits for 2013

Documents

Transcript of Benefits for 2013