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Hebrew Union College 2012 Benefits Presentation

Presented By: Trista Owens, USI Insurance

Jeremy Perlin- Director of Human Resources

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Meeting OverviewMedical Insurance

Base PPO Plan Plan Changes

Buy Up PPO Plan Plan Changes

Lumenos H.S.A. Plan Certificate of Coverage Changes No Change to Employee Contributions

Dental Insurance Plan Design Employee Contributions

New Vision Program Plan Design Employee Contributions

Life/AD&D and Long Term Disability- No Changes

Flexible Spending Account- Short Plan Year

Open Enrollment Procedures and Deadlines

Health Plan Options

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Base PPO PlanIn Network- Anthem National Blue Card NetworkCalendar Year Benefits Deductible- Single $1,000; Family $2,000 Coinsurance- 80% Anthem; 20% MemberOut of Pocket Maximum- Single: $3,000; Family $6,000Office Visit Primary Care Physician- $25 copayOffice Visit Specialist $50 copayEmergency Room- $200 copayUrgent Care- $75 copayPrescription Drugs- $100 deductible per person per calendar year then $10 Tier 1; $30 Tier 2; $50 Tier 3Mail Order- 90 day supply for 2.5 copaysLifetime Maximum- Unlimited

This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine

coverage and eligibility.

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Buy Up PPO PlanIn Network- Anthem National Blue Card NetworkCalendar Year Benefits Deductible- NoneCoinsurance- 90% Anthem; 10% MemberOut of Pocket Maximum- Single: $1,000; Family $2,000Office Visit Primary Care Physician- $20 copayOffice Visit Specialist- $40 copayEmergency Room- $75 copayUrgent Care- $35 copayPrescription Drugs- $10 Tier 1; $30 Tier 2; $50 Tier 3Mail Order- 90 day supply for 2.5 copaysLifetime Maximum- Unlimited

This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine

coverage and eligibility.

Lumenos High Deductible Health Plan/H.S.A. Plan Overview

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Your Lumenos In Network H.S.A.Plan Details At-a-Glance

Lumenos Plan Single Coverage Family Coverage

Preventive Nationally recommended services No cost, no deduction from HSA with in-network providers

Traditional Health Coverage

Annual Calendar Year Deductible- You will be given credit for any

deductible met from 1/1/12 through 6/30/12 (if you are currently in the Base

PPO plan)

$3,000 $6,000 Non-Embedded

Medical ServicesPrescription Copays after the

deductible is met

100% for In-Network ServicesTier 1: $10; Tier 2: $30; Tier 3 $50; Tier 4:

25%

HSAYou can use the funds from your Health Savings

Account to help satisfy your annual

deducible

Employer’s allocation (Half will be funded 7/1/12 and the other half 1/1/13)

Annual 2012 & 2013 IRS HSA contribution maximum combined

between the employer and the employee

$1,000

$3,100 (2012)$3,250 (2013)

$2,000

$6,250 (2012)$6,450 (2013)

This is a brief summary of benefits and does not state all of the provisions of the plan. The terms of each plan will determine coverage and

eligibility.

How Does the Lumenos Plan Work?

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Lumenos Plan with an HSAWith the Lumenos plan, you have a high deductible medical plan coupled with a Health Savings Account (HSA)

• You can fund your HSA with pre-tax payroll contributions or post-tax contributions (which are deductible when you file your taxes)

• The money in your HSA can be used to pay for your medical care, including prescriptions that go towardsatisfying your deductible

• Once you’ve satisfied your deductible the plan’s Traditional Health Coverage prescription copays kicks in.

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Using Your Lumenos Plan to Get CareWhen you visit an in-network doctor:

Show your ID card at the time of service Typically you pay nothing at the time of service. Your provider will file a claim You will receive a Claim Recap showing the total cost and the “allowed” cost. Your

provider will then bill you for the “allowed” cost of the service(s) If you have funds in your HSA you can pay your provider using your HSA

checkbook or debit card

When you visit a doctor that is not in the network: Show your ID card at the time of service You may be asked to pay at the time of services. Use your HSA checkbook or debit card to pay your provider for services (provided

you have the funds available) If your provider does not file a claim on your behalf, you will need to file a claim

with Anthem BCBS to ensure expenses get applied towards your out-of-pocket. You can download a claim form at anthem.com

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Using Your HSA Plan to Get CareWhen you visit a pharmacy:

Show your ID card at the pharmacy

Until you have satisfied your annual deductible you will pay the full discounted cost of your prescription drug

You can pay for your prescription at the pharmacy using your HSA debit card or checkbook as long as there are funds available in your HSA account.

After the deductible is met you will pay the applicable copays of $10/$30/$50/25%.

Using your HSA for Qualified Medical Expenses

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Can I Use My HSA to Pay for Non-Qualified Medical Expenses?

Yes, but… Any amount you spend will be considered taxable income (you

will have to pay taxes on the amount used), and you will have to pay a 20% penalty.

Non-qualified expenses will not count toward your deductible. Once you are 65, you can withdraw the money without penalty,

but it will be considered taxable income.

Funding Your HSA

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Making Contributions to Your HSAThere are several ways you can contribute to your account:

Tax-free through payroll deductions Post-tax by personal check

When you file your taxes, you can make an adjustment to your gross income to receive the tax benefit

Anyone may contribute to your HSA, provided the total contributions to your HSA do not exceed your maximum allowable annual limit

$3,100 for individual coverage in 2012 ($3,250 in 2013) $6,250 for family coverage in 2012 ($6,450 in 2013)

You can make catch-up contributions if you are 55 years of age or older ($1,000 for 2012 and 2013)

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Am I Eligible for the HSA Plan?The IRS and the U.S. Department of the Treasury have

specific rules on who can open an HSA. You can open an HSA if you:

Are enrolled in the Lumenos HSA plan, because it includes an HSA-compatible health plan

Are not enrolled in Medicare or another non-qualified plan Are not claimed as a dependent on another

individual’s tax return Are not active military Others – refer to IRS publication 502

Note: You cannot open an HSA if you have coverage under any other health plan that is not an HSA-compatible health plan.

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Who is Holding the Funds in My HSA?A qualified financial institution will hold and invest the money. Hebrew Union has Partnered with 5/3.

Services provided: Your debit card and PIN Your HSA checkbook FDIC insurance Monthly account statements Year-end tax forms

*If your employer has selected a financial institution to administer your HSA that is not one of Anthem’s partner banks, or you choose to have your HSA at a different bank, you will not have access to

HSA information through Anthem Customer Service or the online health site. Investment rules and fees for your account may also vary.

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Anthem Certificate of Coverage ChangesAnthem Blue Cross & Blue Shield is moving HUC-JIR to the most recent Certificate of Coverage language. There are some additional changes being made to the plans. The most significant changes are listed below:

Hospice will be covered in fullHome Health Care Visits will increase to 100 per calendar yearRoutine Vision Screening will be covered but more limited In and out of Network Deductibles will accumulate separately

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Employee Monthly Contributions

Base Plan or HSA PlanThe current Salary Based Tier will continue:Salary under $35,000 is charged 1.75 % for single and 3.25% for Family.Salary $35,000 to $50,000.00 is charged 2.25% for single and 3.75% for family.Salary over $50,000 – is charged 2.75% for Single and 4.25% for family.

Buy Up PlanBuy Up Single = % of salary noted above plus an additional $131.04 per monthBuy Up Family = % of salary noted above plus an additional $393.14 per month

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Dental Insurance- Guardian

The Dental plan design with Guardian will remain the same. In Network- Calendar Year BenefitsDeductible: Single $50; Family $150 (waived for Preventive)Annual Maximum Per Person: $1,000Preventive: Covered in FullBasic Service: Covered at 80% after deductibleMajor Service: Covered at 50% after deductibleOrthodontia: Covered at 50% to $1,000 lifetime maximum per dependent child up to age 19

To look up a provider please log on to www.guardian.com.Customer Service-1-800-541-7846

2012-2013 Monthly Employee ContributionsSingle: $12.70Family: $36.49

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New Vision Insurance

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Vision Insurance- Provider VSP

National Network of Providers- www.vsp.com Select the Network “VSP Choice”WellVision ExamSM

• Thorough eye exam once a year- $10 copay

Lenses every Plan Year• Fully covered, after a $25 copay• Single vision, lined bifocal and lined trifocal• Polycarbonate lenses for children

Frame every other Plan Year• $130 allowance• Plus, 20% off the amount over your allowance• You can choose contacts instead of glasses every Plan

Year• Allowance of $130 applies to the contact lens exam &

contacts

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Vision Insurance- Provider VSP

VSP does not mail ID cards

To print an ID card log on to www.vsp.com. On the left side of the page click on Member Vision Card.  The members name, coverage type, client ID, doctor network and copays appear on the card.  Because it is personalized, it can only be generated and printed on an individual basis, one card at a time, and not en masse. This enhanced card is a convenience for members and is not required for service. 

Monthly Employee Cost

Single: $6.77Employee plus One Dependent: $11.41Employee plus Children: $11.64Employee plus Family: $18.77

Flexible Spending Account

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2012 and 2013 FSA Plan Years- Change from Current

Healthcare reform requires employers to reduce the Healthcare Maximum to $2,500 for calendar year 2013HUC-JIR has elected to offer a short plan year from 7/1/12-12/31/12 to allow a $3,500 maximumGoing forward the HUC-JIR plan will run 1/1-12/312013 Open Enrollment will be held in November for the 1/1/13-12/31/13 Plan Year

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What is a Flexible Spending Account or FSA?

Pay expenses with tax-free moneyThree Accounts- Health Care, Limited Purpose (for HSA participants) & Dependent CareVoluntary election of payroll deductionsMoney held in your nameSubmit claim for reimbursement

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Think of what you buy with your money. . .

DeductiblesRx DrugsCopaymentsDay CareEyeglasses/ContactsLasik SurgeryDental Work

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Flexible Spending Account Health Care ReimbursementEligible Expenses- see FSA packet$3,500 Maximum limit (Short Plan Year) Use worksheet to estimate total expensesCalculate total contribution

Dependent Care ReimbursementEligible Expenses- see FSA packetIf married, spouse must work or attend school full-timeMaximum - $5,000 for single or married filing joint tax return, $2,500 married filing separate return

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Flexible Spending Account Limited Purpose AccountLimited Purpose Flexible Spending Account is a tax savings account that reimburses employees for eligible dental and vision care expenses in conjunction with a HSA.

Eligible Expenses- dental and vision only$3,500 Maximum limitUse worksheet to estimate total expensesCalculate total contribution

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Open Enrollment Summary

Health Insurance- If you would like to enroll, add or drop dependents, switch plans or cancel your coverage please complete an enrollment form. If you have no changes to make no forms are required.

Vision- If you would like to enroll in the new VSP Vision plan please complete an enrollment form.

FSA- Please complete the enrollment form and turn it into the Cincinnati Benefits department

If you would like to make any changes to your Dental, Life or Supplemental Life please contact HR for a change form. As a reminder there is not an open enrollment for Dental. If you would like to increase your supplemental life insurance evidence of insurability is required. You will be approved or declined based on your current health status.

ALL FORMS ARE DUE TO HR NO LATER THAN JUNE 11th, 2012

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Questions?