2009-2010STATE OPEN ENROLLMENT

Agenda

• Mandatory Open Enrollment • Dependent Eligibility and Reporting Changes• Cost-sharing Changes• Coverage Changes• Employee Benefits Communications

– Guide– Benefits Open Enrollment website– Expo and Information Meetings– Contact Information

2009–2010 ADOA Open Enrollment

Thursday, Aug. 20 – Friday, Sept. 4 at 5 PM• All employees must re-enroll

– If not, will be randomly defaulted into medical EPO

• Changes effective Oct 1st • Rates effective with Oct 9th paycheck• Plans: medical, dental, vision, short-term

disability, supplemental life and dependent life (not Aetna).

2009-2010 Open Enrollment

• Highlights of 2009-2010 Open Enrollment– Cost-sharing– New Coverage Tier– Elimination/reduction of some benefits– New Plan Design– New Vendors– We’re learning with you!

Cost Sharing Changes

• Monthly Medical and Dental Rates Increase– New Medical 4-tier Rate Structure - (for single; emp + 1 child; emp + 1 adult;

family) to align premiums with costs– Moderate to significant rate increases for EPO and PPO participants– New Vision 3-tier Rate Structure as Dental– Same employer contribution for both Dental Plans

• Higher Out-of- Pocket Costs – Higher co-payments in EPO– Higher coinsurance and deductibles in PPO– New HSA Option with HealthFund HSA for out-of-pocket costs

2009-2010 Health Plan Changes

• New Pharmacy Benefits Vendor: MedImpact• New EPO/PPO Medical Networks: Aetna, AmeriBen,

CIGNA & UHC– Statewide & National Coverage – eligibility no longer based on Home

Address– Transition of Care – Details available on website– International – EPO/HSA (Emergency & Urgent Care Only;

PPO (Emergency & Urgent Care at In-Network Benefit Level)

Health Plan Cont’d

EPOEPOPer PayPer Pay

PPOPPOPer PayPer Pay

HSAHSAPer PayPer Pay

Employee $18.00 $71.08$11.54

EMP + Adult $44.77 $151.38 $36.92

EMP + Child $36.46 $142.62$27.23

Family$82.15 $204.46 $69.23

Coverage Changes

• Prescription Drugs – “Dispense as Written” Brand Name (if generic available) must pay

copayment plus difference in cost between brand and generic

– Limited to meds that do not have equally effective over-the-counter substitute

– Existing active prescriptions will continue

• Home Health limited to 168 hours per plan year• Bariatric Surgery covered if 35+ body mass index

plus two or more medical conditions:– Type 2 diabetes, coronary heart disease, stroke, gallbladder disease,

osteoarthritis, sleep apnea, respiratory problems, and certain cancers

Coverage Changes

• Co-pays/Deductibles

EPO – No DeductiblePCP $15Specialist $30Preventative $15OB/GYN $10

Coverage Changes

PPO – Must Meet Deductible FirstDeductible:

In-Network:Individual $500Family $1,000

Out-of-NetworkIndividual $1,000Family $2,000

Co-pays:In-Network:

PCP $15Specialist $30Preventative $15OB/GYN $10

Out-of-Network: 50% Subject to Deductible

Coverage Changes

EPO• Outpatient Services $50• Emergency

– Ambulance $ 0– ER $125– Urgent Care $40• Hospital Admission $150• Maternity Admission $250

Per baby

Coverage Changes

PPO – In-Network

• Outpatient Services $50 • Emergency

– Ambulance $ 0– ER $125– Urgent Care $40• Hospital Admission

$150• Maternity Admission

$250

Per baby

PPO – Out-of-Network

• Outpatient Services 50%

• Emergency

– Ambulance – Amount above In-Network Rate

– ER $125

– Urgent Care 50%

• Hospital Admission 50%

• Maternity Admission 50%

Coverage Changes

• Services no longer covered:

– Cosmetic Surgery Complications– Erectile Implants– Infertility Services– Surrogacy– TMJ Surgery

Health Plan Changes cont’d

• Avesis renewed, but will also provide a discount card to employees who waive vision insurance

• Dental contract was not subject to renewal• Introduction of Health Savings Account Option

What is an HSA?• Health Savings Account (HSA) Option

– High deductible health plan

– Most in-network services

• You pay 100% up to deductible

• 10% up to coinsurance maximum

• 0% for the remaining part of the plan year

– Most out-of-network services

• You pay 100% up to deductible

• 50% up to coinsurance maximum

• 0% for the remaining part of the plan year

• HealthFund HSA for out-of-pocket costs

– ASU contributions & Elective employee contributions

– If withdrawals are more than HealthFund balances, subject to “overdraft” fees

– If used for non-medical expenses, subject to additional fees

Dental

PER PAY PERIOD PREMIUMSPER PAY PERIOD PREMIUMSEffective – October 1, 2009

SingleSingle Employee + 1Employee + 1 FamilyFamily

Pre-Paid Pre-Paid

Total DentalTotal Dental $2.23 $6.24 $6.46

PPO/IndemnityPPO/Indemnity

Delta DentalDelta Dental $13.78 $31.35 $54.52

Vision – Per Pay Period

SINGLE EMPLOYEE + 1 FAMILY

$2.23$2.23 $6.24 $7.78

2009-2010 Life & Disability Changes

– Short-term Disability & Life Insurance Vendor: Hartford

• Hartford replaces all products previously offered by The Standard Insurance Company (STD, LTD, Basic and Supplemental Life)

• No changes to university options under UNUM• Aetna is not included in this open enrollment, all enrollments remain• ASU Life – New ASU Open Enrollment Options in November

– No plan design change for short-term disability– No plan design change for ADOA’s supplemental life– Only design addition is to dependent life – 50,000

option for employees with at least 35,000 in supplemental life

Employee Resources

Employee Resources cont’d

Coming Soon…ASU Open Enrollment

• November 1st through 30th – Flexible Spending Account

• Health Care FSA• Dependent Care FSA

– Possibly new life and long-term care options

• Effective January 1, 2010

How to Enroll?

• Link from Open Enrollment: – www.asu.edu/hr/benefits/2009OE_generalinfo.html

• My ASU: – my.asu.edu

Dependent Eligibility and Reporting

• Federal legislative change – Mandatory Insurer Reporting Law

(Section 111 of Public Law 110-173) Effective Jan 1, 2009

– Must submit dependent/spouse Social Security numbers to continue dependent coverage

Dependents cont’d

– Exceptions

• 6-8 week grace period for newborns; and

• Dependents with Visas– Must provide copy of Visa

– ASU communication mailed to home week of August 17th

– System requires SSN for any new dependent or edits on existing dependents.

• NOTE: Due to system set-up, beneficiary SSNs are required when entering new or editing an existing beneficiary. Employees may submit a form to enter a beneficiary without an SSN.

Dependents cont’d

MAY WE ANSWER YOUR QUESTIONS?