Healthcare Benefits Training: Exploring the New HDHP with HSA and Other benefit changes for all...

Healthcare Benefits Training:Exploring the New HDHP with HSA

and Other benefit changes for all employees in 2008

2

Topics We’ll Cover Today• Healthcare benefits – what’s new for 2008?• The new High Deductible Health Plan (HDHP)

with Health Savings Account (HSA) – Plan design– Components– How it works

• Paying for healthcare– ID card changes for all plans– Paying for expenses under the HDHP with

HSA• Tools and resources• Reimbursement accounts• Enrollment next steps

Healthcare BenefitsHealthcare Benefits

What’s New for 2008?

4

Highlights: What’s new for 2008?• UnitedHealthcare is the new administrator for all:

– Medical plans– Healthcare and dependent care reimbursement accounts– Employee Assistance Programs (EAP)

• Exante Bank is the designated trustee for HSAs• Medco is the pharmacy plan administrator for all plans

• Includes the NSP bargaining 150 plan• Dental, vision and life insurance will continue to be administered by the

current vendors• Disability benefits will be administered by The Hartford• Transportation Reimbursement Accounts will be administered by Flex

Compensation• New network for all medical plans• Health assessment incentives are still available but not required to

enroll in a medical plan– $25 HSA contribution for HDHP with HSA participants– $25 gift card for all other medical plans– Retirees and PSCo Bargaining are not eligible for the incentive

5

Highlights: What’s new for 2008?

Your eligible plan options

New HDHP with HSA replaces PPO $0 for Non-bargaining- New option for SPS Bargaining

- NSP Bargaining TBD

PPO $200

- Non-bargaining and SPS Bargaining only

PPO $400

- Non-bargaining, NSP Bargaining and SPS Bargaining

Bargaining 150

- NSP Bargaining only

POS - PSCo Bargaining only

6

Why Are We Offering a New Plan?

What we want to do:– Encourage employees to actively engage in controlling

healthcare costs– Minimize routine premium contribution increases and

manage escalating health costs– Create an additional savings vehicle for the future

How the plan will support you:– Comprehensive benefits and innovative resources

• Preventive care covered 100% in network• Web tools, drug comparisons and modeling prescription

drug costs• Other cost and quality resources• Care management, health coaches (nurses), disease

management and health improvement programs

7

What’s Covered Under the HDHP with HSA?

•Flu shots are covered 100% in network

•Mental health – limits removed

•Substance abuse – no lifetime maximum in network

– Outpatient: 130 visits per year with no lifetime maximum in network

– Inpatient: no limit

Covers the same medical and pharmacy expenses as the PPO Options with additional improvements:

8

What’s Covered Under the HDHP with HSA? (cont.)

• Hearing aids - $1,000 per ear, every 36 months• Travel and lodging benefit for transplant network

facilities• Certain drugs will have a significantly reduced cost

– Oral contraceptives– Geriatric, pediatric and prenatal vitamins– Weight loss agents– Fluoride preparations (tab chews/lozenges) for

tooth decay– Disulfiram (Antabuse) for treatment of alcohol

abuse

9

Fitness Discount Program – What’s New

• All qualified fitness centers are included in the program– Must offer strength training and cardiovascular machines

• Administered by UnitedHealthcare• You and a covered dependent over age 18 are still

eligible for fitness center discounts– $20 reimbursement per month – $40 maximum reimbursement per month for each household– Must frequent a fitness club 8 times a month

• Reimbursement will now require a signature from your fitness center verifying your attendance

• Claim forms can be found online or by calling UHC• Available for active Non-bargaining and SPS Bargaining

(NSP Bargaining TBD)

The HDHP with HSA The HDHP with HSA

11

Some Basics You Need to Know

• What’s covered by the new HDHP with HSA remains the same, or has been improved

• What’s different is how you pay for care• To understand how to pay for care, you will

need to know the actual cost of medical services and prescription drugs

• In-network prices will still reflect discounts• Impact of Dual Coverage

12

Your HDHP with HSA OptionsEmployee Only Coverage

Xcel Pays:

You Pay:

100%/70%

0%/30%

In/Out-of-Network Coinsurance

In/Out-of-NetworkDeductible

Preventive Care

Premiums

Your payment choices:

1) Xcel’s contribution to your HSA = $560

2) Your own pre-tax contributions to your HSA

3) Money from your pocket

100%

0%

$0

$2,500/$3,750

100%

0%

13

Your HDHP with HSA OptionsFamily Coverage

Xcel Pays:

You Pay:

In/Out-of-NetworkCoinsurance

In/Out-of-NetworkDeductible

Preventive Care

Premiums

Your payment choices:

1) Xcel’s contribution to your HSA = $1,120

2) Your own pre-tax contributions to your HSA

3) Money from your pocket

100%/70%

0%/30%

100%

0%

$0

$5,000/$7500

100%

0%

14

HDHP with HSA – Family Deductibles

Assuming in network:• $5,000 is the most a family will pay for

covered expenses• If one family member spends $2,500 in

covered expenses, any additional expenses will be covered 100% in network for that person only the rest of the plan year

• If two or more family members spend a total of $5,000 in covered expenses, any additional expenses will be covered 100% in network for the entire family

15

Your HDHP with HSA Components

• A High Deductible Health Plan (HDHP) includes these features:– Preventive care– Deductible – amount you need to pay before health

coverage begins– Coinsurance – 100% in-network and 70% out-of-

network coverage once the deductible has been met• A Health Savings Account (HSA) – a certain amount

funded by Xcel Energy with an opportunity for you to make pre-tax payroll contributions

• Resources to help you save money and manage your health benefits

CoinsuranceDeductiblePreventive

Care

1

2

3

16

Your HDHP with HSA Components (cont.)

• High Deductible Health Plan – Preventive Care

• Covered 100% in network, not subject to deductible

• Common preventive care services include:– Well child visits– Adult annual exams– Immunizations and screenings– Mammograms– Pap smears– Colonoscopies

1

For a full list of preventive care services covered at 100%, go to: myuhc.com/groups/xcel

Preventive Care

17


• High Deductible Health Plan – Deductible• All covered non-preventive expenses (including

pharmacy) count toward your deductible• Separate in- and out-of-network deductibles• You decide how you pay for expenses before you

reach the deductible– Xcel Energy’s HSA contribution– Pre-tax dollars you contribute to the HSA via payroll

contributions– Money from your own pocket or bank account (after

tax dollars)

1

DeductiblePreventive

Care

18


• High Deductible Health Plan – Coinsurance• In-network Coinsurance

– After you satisfy your deductible, Xcel pays 100% of in-network eligible medical and pharmacy expenses

– Expenses must be covered under the plan to be paid at 100%

• Out-of-Network Coinsurance– After you satisfy your deductible, Xcel pays 70% of

eligible medical and pharmacy expenses and you pay 30% up to an annual maximum

• No lifetime maximum

1

CoinsuranceDeductiblePreventive

Care

19


• Health Savings Account (HSA)• Your HSA belongs to you. The entire account remains yours – even if you leave

Xcel Energy • Certain amount funded by Xcel Energy• You can make pre-tax payroll contributions• You must open the HSA with Exante Bank to receive Xcel Energy’s contributions or

to make pre-tax payroll contributions

• IRS 2008 maximum HSA contributions (including amount funded by Xcel Energy)– $2,900 Employee-Only Coverage– $5,800 Family Coverage– $900 Catch-up contribution for 55+

• Use for qualified medical services and prescription drugs to receive the pre-tax advantage

• Or, pay for your expenses without the account and let your HSA balance grow – 4% interest on all balances in 2008– Mutual fund investment options for balances greater than $2,000– Interest and investment income is tax-free and can add to your retirement

funds

2

20


• Benefits and Resources for All Plans• During Open Enrollment

– Find your in-network provider – Cost Estimator– Customer Service

• Throughout the Year– Health Assessment– Personal Health Record– Customer Service– Personalized Health Support– Maternity Program– Premium Program– Fitness Center Discount Program

3

The HDHP with HSA The HDHP with HSA

How it Works

22

Sean• Single• Suffers from severe headaches

– Non-bargained employee-only coverage– $2,500 in-network deductible– $560 HSA contribution from Xcel– $25 Health Assessment incentive– 100% coverage in network after deductible

23

SeanContribution to HSA $0 $560+$25

Healthcare Expenses

Employee-Only Coverage (annual premiums) $0$3,808Preventive Care Annual Physical $120 $0 $120

Office visit $100 $100 $0

Total Healthcare Expenses $100 $3,928

Xcel Energy Pays

Total

$585

$0

$0

$0 $500 $1,000 $1,500 $2,000 $2,500

Deductible Satisfied

HSA $585

$100

Sean’s HSA balance at year-end:

$485

$485

Sean Pays

24

Sean’s Out-of-Pocket Cost Comparison

Plus, Sean has $485 remaining in his HSA

Employee-Only Coverage (annual premiums) $0$1,236

Xcel Contribution to HSA $560$0

Health Assessment Incentive $25$25 gift card

Annual Physical $120 $0$24

Office visit $100 (HDHP paid with Xcel HSA Contribution)$100$100

Total Out-of-Pocket Expenses $0$1,360

HDHP with HSA

PPO $200

25

Julie• Covers her spouse and child• Expecting another child

―Non-bargained family coverage―$5,000 in-network deductible―$1,120 HSA contribution from Xcel―$3,880 HSA contribution from Julie―100% coverage in network after deductible

26

JulieContribution to HSA $3,880 $1,120

Family Coverage (annual premiums) $0 $11,423

4 Well Baby Visits, 1 Well Child $470 $0 $470(preventive care covered 100%)

Total Healthcare Expenses $3,100 $21,393

Julie Pays Xcel Energy Pays

Healthcare Expenses

Total

$5,000

Prenatal Care, Delivery, Nursery Care $12,000 $2,500$9,500

Julie’s Spouse: $600 $01 Office visit and 6 prescriptions $600

$0

$0

$0

$0 $1,000 $2,000 $3,000 $4,000 $5,000

Spouse's Deductible Satisfied

Julie's Deductible Satisfied

HSA $5,000

$600

$2,500

Julie’s HSA balance at year-end:

$1,900

$2,500

$1,900

27

Nathan• Covers his spouse• Coronary bypass surgery

―Non-bargained employee and spouse coverage―$5,000 in-network deductible―$1,120 HSA contribution from Xcel―$3,880 HSA contribution from Nathan―100% coverage in network after deductible

28

Nathan Contribution to HSA $3,880 $1,120

Employee + Spouse Coverage (annual premiums) $0$8,377Nathan’s Coronary Bypass Surgery $56,850$2,500 $54,350

• ER visit• Surgery• Hospitalization• Follow-up cardiologist visit


Nathan Pays

Xcel Energy Pays

Healthcare Expenses

Total

$5,000

Nathan’s spouse: Maintenance meds $800$800 $0

$0

$0

$0

$0 $1,000 $2,000 $3,000 $4,000 $5,000

Spouse's Deductible Satisfied

Nathan's Deductible Satisfied

HSA $5,000

$800

$2,500$2,500

$1,700

Nathan’s HSA balance at year-end:

$1,700

29

John• Single• Has diabetes

―Non-bargained single coverage―$2,500 in-network deductible―$560 HSA contribution from Xcel―$25 Health Assessment contribution―$1,915 HSA contribution from John―100% coverage in network after deductible

30

JohnContribution to HSA $1,915 $560+$25

Single Coverage (annual premiums) $0 $3,808

Preventive Care Annual Physical $120 $0 $120

5 Specialist Visits $450 $450 $0


John Pays

Xcel Energy Pays

Healthcare Expenses

24 Prescriptions $3,000 $2,050 $950

Total

$2,500

$0

$0

$0 $500 $1,000 $1,500 $2,000 $2,500


HSA

John’s HSA balance at

year-end: $0

$2,500

$2,500$450

$2,050

31

Steve• Covers his spouse and 2 children

― Non-bargained family coverage― $5,000 in-network deductible― $1,120 HSA contribution from Xcel― $4,000 HSA contribution from Steve― 100% coverage in network after deductible

32

SteveContribution to HSA $4,000 $1,120

Family Coverage (annual premiums) $0 $11,423

Preventive Care Annual Physicals and Mammogram $550$0 $550

Steve: Lipitor – Annual Cost $1,379$ 1,379 $0

Steve’s spouse: 5 Chiropractor Visits $375$375 $0

Steve’s spouse: Fluoxetine $164 $164 $0

Steve’s kids: 2 Office Visits, Lab, Strep Test $250 $250$0Total Healthcare Expenses $2,168 $11,973

Steve Pays

Xcel Energy Pays

Healthcare Expenses

Total

$5,120

$0

$0

$0 $1,000 $2,000 $3,000 $4,000 $5,000


HSA $5,120

$2,168

$2,952

Steve’s HSA balance at year-end:

$2,952

33

In the new HDHP with HSA, the most you could potentially pay out-of-pocket if you stay in network is:

a) The amount you pay in premiumsb) Your premiums plus the deductiblec) The deductible – less the Xcel contribution to your

HSAd) Your premiums and coinsurance for any amount

after you meet the deductible – less the Xcel contribution to your HSA

Quick Quiz

34

Quick Quiz (cont.)

In the new HDHP with HSA, the most you could potentially pay out-of-pocket if you stay in network is:

c)The deductible – less the Xcel contribution to your HSA

Paying for HealthcarePaying for Healthcare

36

Medical and Pharmacy ID Cards1. Medical ID cards will arrive before

January 1― Different ID cards for Medica and UHC― Employees living in Minnesota, North Dakota, South Dakota

and parts of western Wisconsin have the Medica network― All other employees will utilize the UHC network

2. Pharmacy ID card― Medco administers all pharmacy plans, including NSP

Bargaining 150― Use the same ID card as last year unless you enroll in the

HDHP with HSA or you are currently enrolled in the Bargaining 150 plan

Individuals enrolled in the HDHP

will receive a MasterCard to access HSA funds

37

Follow these steps when receiving care:1. Present your medical ID card and have your network

provider send your claim to UHC for processing 2. UHC will review your claim and apply applicable network

discounts3. Your network provider will bill you for any revised amount

you owe4. If you have enough money in your HSA, you can use your

HSA debit card or you can pay this expense yourself, then request reimbursement from your HSA• If you want to save your HSA funds (the interest grows tax-free), you

can pay your provider with after-tax dollars from your personal checking account

• Remember: Xcel’s full 2008 contribution will be deposited January 15

Paying for Medical Care with Your HSA Fund

38

Access your account online or by calling 1-800-326-5506

• Use your HSA MasterCard prepaid debit card– At the pharmacy– At ATMs displaying the MasterCard

brand mark– On provider’s invoice, just write in debit

card number

• Online bill payment at www.myuhc.com

• Checks, if you wish to purchase them• Use for qualified medical expenses

only or purchases will be subject to income taxes and 10% penalty

• Debit Cards will arrive in the mail by January 15

Easy Access to Your HSA Funds

39

Paying for Prescription Drugs with Your HSA Fund

• You pay the pharmacy at the time of purchase• You pay the full discounted, in-network price for

prescription drugs until you meet your deductible• If you have a sufficient HSA balance, you can use

your HSA debit card starting in January to pay for expenses– If you purchase drugs before receiving your debit card,

you can pay this expense yourself, then request reimbursement from your HSA

– If you wish to save your HSA funds and enjoy tax-free compound growth, you can choose to pay for your prescriptions with after-tax dollars from your personal checking account

40

Filing Your Taxes• At the end of each year, Exante Bank will send you:

– 5498-SA detailing contributions– 1099-SA detailing withdrawals

• Use these to complete IRS tax form 8889; file this form with your returns

• Withdrawals from your HSA are tax-free as long as they are used to pay for qualified medical expenses– If spent otherwise, income taxes + 10% penalty apply – 10% penalty does not apply for 65+

• You are responsible for maintaining records of eligible expenses paid through your HSA – If your tax return is audited, you may be asked to provide

receipts to confirm eligibility of reimbursed expenses

Reimbursement AccountsReimbursement Accounts

42

Reimbursement AccountsHealthcare Reimbursement Account (for non-HDHP participants

only)• Pay for qualifying medical and prescription drugs with pre-tax dollars• Dental work, eyeglasses, hearing aids, batteries, over-the-counter

medications• $2,500 annual limit for SPS Bargaining• $5,000 annual limit for all other employees

New Limited Purpose FSA (for HDHP participants only)• For HSA enrollees who still want to participate in the healthcare FSA• Spouses cannot have a traditional healthcare spending account

through their employer

• Can only be used for dental and vision with pre-tax dollars• $5,000 annual limit

Unlike the HSA, funds can be accessed before you have contributed them“Use it or lose it” rule still applies

43

Reimbursement Accounts (cont.)

Dependent Care Reimbursement Account • Pay for qualifying child or adult daycare expenses with

pre-tax dollars• $5,000 annual limit

Transportation Reimbursement Account • Pay for parking and vanpooling expenses with pre-tax

dollars• $215/month for parking, $105/month for vanpooling• Note: Bus passes and Valuepass are not eligible expenses

“Use it or lose it” rule still applies.You forfeit funds at end of the year if you do not use them.

Tools and ResourcesTools and Resources

During Open Enrollment and

Throughout the Year

45

Tools and Resources During Open Enrollment

UnitedHealthcare pre-enrollment website: myuhc.com/groups/xcel

• Find in-network physicians and facilities – Minnesota, North Dakota, South Dakota and western Wisconsin have the

Medica Network– All other areas utilize UnitedHealthcare Network– Verify participation with your doctor

• Research the average cost of medical services • Cost estimator – estimate out-of-pocket costs based on your situation

– Go to BCBS website www.bluecrossmn.com/servicecenter/xcelenergy to research costs you had for the prior year

Prescription drug prices on Medco website: Medco.com• Find information on drug costs and alternatives by selecting “My Rx

Choices”

Frequently asked questions posted on myHR website: From home – www.HR.xcelenergy.comAt work - http://xpressnet/myhr

46

Tools and Resources Throughout the Year

The UnitedHealthcare Customer Care Now Open

1-800-326-5506

Personalized, password-protected website:www.myuhc.com

All the resources available on the pre-enrollment website and more:

• UnitedHealth Premium programs – quality and cost information about physicians and hospitals

• Personal Health Record• Health Assessment – employees and their spouses can each

earn $25• My Account

47

Plan Cost Estimator Tool

• Tool compares plans and in and out of network costs

• Based on the information entered by you, it will give you out of pocket costs overview

• Allows you to model a variety of health conditions for you and your family members

• Premiums are entered into the tool

48

Trained specialists, nurses and other medical professionals

• Nurseline• Treatment Decision Support• Disease Management• Transition of Care for those currently enrolled in

BCBS programs• Completely confidential• Available any time, day or night• Call the number on the back of your medical ID

card

Tools and Resources Throughout the Year (cont.)

49

Healthy Pregnancy Program• Soon-to-be mothers can receive support through

every stage of pregnancy and delivery• Talk to a nurse toll-free as needed – 24/7• Take a personalized pregnancy assessment• Receive a free book about your pregnancy

journey and a Healthy Baby Bag

Tools and Resources Throughout the Year

50

Know the plans – HDHP versus PPO features and benefits Know your doctors and pharmacist – determine if your

providers are in the network

Consider your health • Prior year healthcare costs for you and your family – go to

www.bluecrossmn.com/servicecenter/xcelenergy• Expected healthcare costs – medications, tests, provider visits

Do the math – consider both your premium contributions and out-of-pocket costs in total under each option

For help on out-of-pocket costs, try the medical plan cost estimator to model potential costs: myuhc.com/groups/xcel

Things to Consider When Choosing Your Plan for 2008

51

1. Enroll October 29-November 12 (NSP Bargaining dates TBD)• Enroll at work – http://xpressnet/myhr• Enroll from home – www.HR.xcelenergy.com

2. Select a healthcare option:• HDHP with HSA• PPO $200• PPO $400• Bargaining 150• POS – PSCo Bargaining

3. If you choose the HDHP option, elect your HSA contribution• Your allowable HSA contribution less the Xcel contributions• Plus, if you’re age 55+, you can make an additional $900

catch-up contribution in 2008

What You Need to Do Next

52

4. Decide whether to contribute to a healthcare FSA• If you elect the HDHP with HSA, you can enroll in the

limited purpose healthcare FSA• If you elect any other plan options, you can enroll in the

regular healthcare FSA• Elect an amount for payroll deduction

5. Elect your remaining benefit choices6. Review your confirmation statement to ensure all

information is accurate and report any discrepancies

You’re enrolled!

What You Need to Do Next (cont.)

Contact the HR Service Center at 1-800-689-7662 with any questions.

Healthcare Benefits Training: Exploring the New HDHP with HSA and Other benefit changes for all...

Documents

Transcript of Healthcare Benefits Training: Exploring the New HDHP with HSA and Other benefit changes for all...