Spring Tour 2016

Montana University SystemEmployee Benefit Plan

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ANNUAL BENEFIT ELECTION PERIOD

For the FY2017 benefit year July 1, 2016 – June 30, 2017

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Spring Tour 2016

Montana University System

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Agenda for Today Important Changes for FY2017

1. Mid-Year Change Recap2. Rehabilitation Benefit Changes3. Wellness reminders

Benefit Changes and your Decisions for FY2017

1. Medical, Dental, and Vision2. Rates and Fees

Time Frames for Making Benefit Change Decisions

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Important Changes for FY2017MID-YEAR CHANGE RECAP

BENEFIT DESCRIPTION BENEFIT THROUGH DECEMBER 30, 2015

CHANGE AS OF DECEMBER 31, 2015

CopaymentsOffice Visits (non-specialty)

$15 $25

Specialty Visits $15 $40Emergency Room Facility Visits

$125 $250

Urgent Care Visits $50 $75URx Copays Tier A (retail/mail) $0/$0

Tier B (retail/mail) $15/$30Tier C (retail/mail) $40/$80Tier D (retail/mail) 50 %Tier F (retail/mail) 100%

Tier A (retail/mail) $0/$0Tier B (retail/mail) $25/$50Tier C (retail/mail) $60/$120Tier D (retail/mail) 50 %Tier F (retail/mail) 100%

URx Specialty Copays Specialty $50/ Specialty $200 Specialty $150/ Specialty $300Deductible

Increase In-Network Deductible

$500 (individual)/$1,000 (family)

$750 (individual)/ $1,500 (family)

Out-of-Pocket MaximumsIncrease In-Network Medical OOP

$3,500 (individual)/$7,000 (family)

$4,000 (individual)/$8,000 (family)

Increase Rx Out-of-Pocket

$1,650 (individual)/$3,300 (family)

$2,150 (individual)/$4,300 (family)

Other Benefit AdjustmentsInfertility Treatment Covered – see Summary Plan

Description for detailsNot covered – plan exclusion

Vision Hardware Benefit See full description at www.choices.mus.edu/Vision.asp

$300 frames and lenses maximum annual allowance , in lieu of contacts $150 contacts maximum annual allowance, in lieu of frames and lenses

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Important Changes for FY2017REHABILITATION BENEFIT CHANGES Rehabilitative Services will be expanded to include Acupuncture and Chiropractic Services.

BENEFIT DESCRIPTION IN-NETWORK COPAY/COINSURANCE

OUT-OF-NETWORK COPAY/COINSURANCE

REHABILITATIVE SERVICES

Inpatient Services (Pre-certification is strongly recommended) 

25% 35%

Max: 30 days per year (all therapies combined)

Outpatient Services $25 copay /visit 35%Max: 30 visits per year (all therapies combined)

Covered Rehabilitative Services Include: Physical Therapy Occupational Therapy Speech Therapy Cardiac Rehabilitation Respiratory Rehabilitation Pulmonary Rehabilitation Acupuncture Chiropractic

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Important Information for FY2017

Selection Of Medical Plan - WE WILL CONTINUE OFFERING THREE MEDICAL

PLAN OPTIONS IN FY2017

Allegiance Managed Care Blue Cross and Blue Shield Managed Care Pacific Source Managed Care

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Important Information for FY2017 (cont.)

Use In-Network Providers – Be sure to use In-Network providers to ensure you do not

incur “balance billing” charges. Network participation by

providers is changing in the health care market.

Always check - DO NOT assume participation “….but my doctor has always been In-Network!”

Check with your medical plan vendor, MUS Benefits Office, or your campus if you need help finding In-Network providers.

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Important Information for FY2017 (cont.)

ELIGIBILITY Dependents up to age 26 may enroll

annually in medical, dental, and vision benefits. (Does not include spouses)

Proof of eligibility according to criteria in the Summary Plan Description will be required.

Mid-year disenrollment may onlyoccur with a “qualifying event” orduring a “Special Enrollment Period”.

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Important Changes for FY2017 (cont.)

OPTIONAL VISION HARDWARE

BENEFIT Optional Vision Hardware Benefit covers ONLY hardware. Eyeglass frames and lenses, in lieu of contacts.

UP TO $300 ANNUAL ALLOWANCE. Contacts, in lieu of frames and lenses.

UP TO $150 ANNUAL ALLOWANCE Eye Exam is provided as part of the medical plan. No need to use a network for purchasing hardware – simply select a place to purchase the frames, lenses, or contacts and then submit claims to Blue Cross and Blue Shield.

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Benefit Changes and

Your Decisions for FY2017RATES AND FEES

NON-MEDICARE RETIREES – • 14.7% Aggregate Increase• Premium increases are between $104 and $251 per month depending on

which medical plan you select and whether you cover dependents.

MEDICARE RETIREES –• 20.9% Aggregate Increase • Premium changes range from a $68 per month increase to a $170 per month

increase depending on which medical plan you select and whether you cover dependents.

RETIREE DENTAL –• Retiree rates remain the same as 2016.• Benefits are unchanged.

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Benefit Changes and Your Decisions for FY2017

RATES AND FEES (cont.) VISION HARDWARE PLAN –

• Rates increase by 5.2% or $0.37-$1.07 per month. • Remember – the Medical Benefits cover vision exams!• Optional Vision Hardware Plan covers eyeglass frames and lenses or

contacts

MEDICARE ADVANTAGE PLAN (MUS MAP) –• Rate changes to $225 beginning July 1, 2016 and

continues through December 31, 2017 (18 month rate guarantee).

• MUS MAP will change to a calendar year plan to align with Medicare on January 1, 2017.

• Deductible and out-of-pocket accumulators will reset January 1, 2017.

• Changes to certain benefits – contact New West for more information about the plan offering for July 1, 2016 – December 31, 2017.

• Retreat rights end June 30, 2016.

Health Plans and Networks

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To receive your best benefits, STAY IN-NETWORK with your health plan

Allegiance 1-877-778-8600, www.abpmtpa.com/musBlue Cross and Blue Shield 1-800-820-1674, www.bcbsmt.com PacificSource 1-877-590-1596, www.PacificSource.com/MUS MUS MAP 1-888-873-8049, www.newwesthealth.com

Retiree Updates

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Please review your medical plan choices carefully.

1. Review Managed Care Plan choices carefully.2. If you are a Medicare eligible retiree, consider whether

the MUS Medicare Advantage Plan (MUS MAP) offered through New West Medicare may be an option for you.

Look for the retiree information and updates that will be mailed to your home and/or attend a campus presentation.

Contact your Campus benefit staff or the MUS

Employee Benefits Office if you have questions – we are happy to help!

All forms for any changes must be received by May

20, 2016 and submitted to the appropriate address noted on your enrollment form.

If NO CHANGES are desired, you don’t need to do anything!

If you elect MUS Medicare Advantage Plan (MUS

MAP) rates are guaranteed through December 31, 2017. MUS MAP Benefits are on a calendar year basis beginning January 1, 2017.

QUESTIONS?

Thank you for your time!

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