Fuse 2015 Open Enrollment

December 2014

2

Agenda

• Review all 2015 insurance benefits

• Outline action items for enrollment / changes

• Q & A

3

Summary of 2015

• Health Insurance– Staying with Cigna– Staying with HRAs– Changes to HRA funding, EE OOP Exposure

& EE Contributions• Dental / Vision Insurance

– Changes to EE Contributions• Increased limits for FSA Plan• Increased benefits for STD Plan

4

Cigna

• 24/7 Customer Service• Extensive Provider Network• Competitive Rates• Customizable Plan Designs• Claims Processing

5

Health Insurance & HRAs

Annual Deductibles – no change

Single Two-Person / Family

$5,000 $10,000

HRA plan has changed to include an 80/20 co-insurance

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Health Insurance & HRAs

How does the 80/20 co-insurance work?

1. EE pays first $500 / $1,000 (same as 2014)

2. Fuse / HRA pays 80% of remaining claims up to deductible

3. EE pays 20% of remaining claims up to deductible

Example (EE has a single plan):

EE receives $2,500 hospital bill • EE pays 100% of first $500• Fuse / HRA pays $1,600 (80%) and EE pays $400

(20%) of remaining $2,000

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How claims are paid

EE paysfirst

$500

Fuse HRA pays 80% (up to $3,600)

EE pays 20% (up to $900)

Cigna pays 100%

beyond $5K

Single Plan

$5,000

Excludes prescriptions: Rx $5 / $25 / $50 (up to $1,350) – no change

$0 $500

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How claims are paid

EE Paysfirst$1K

Fuse HRA pays 80% (up to $7,200)

EE pays 20% (up to $1,800)

Cigna pays

100% beyond $10K

Two-Person / Family Plans

$0 $10,000 $1K

Excludes prescriptions: Rx $5 / $25 / $50 (up to $2,700) – no change

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Health Insurance & HRAs

With the new 80/20 co-insurance:

Single

$500

+ 20% of all costs between $500 and $5K deductible

Max Med OOP Exposure = $1,400 (+$900 from 2014)

Two Person / Family

$1,000

+ 20% of all costs between $1,000 and $10K deductible

Max Med OOP Exposure = $2,800 (+$1,800 from 2014)

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What Cigna Covers

Preventive Care Paid at 100%, not subject to deductible

Office Visits 100% after $5K/$10K deductible

Inpatient Hospital 100% after $5K/$10K deductible

Outpatient Services 100% after $5K/$10K deductible

ER Visits 100% after $5K/$10K deductible

Chiropractic Care100% after $5K/$10K deductible Must use network provider, up to 20 visits per year

Prescriptions$5 / $25 / $50, not subject to deductibleMax OOP is $1,350 / $2,700 per year

Mental Health 100% after $5K/$10K deductible

Eye Exams Not covered

Lifetime Benefit Unlimited

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HRAs are administered by Cigna

– NO debit cards

– NO manual submissions

– HRA funds cannot be used for dental, vision or prescriptions

Health Reimbursement Accounts

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Health Reimbursement Accounts

HRA Overview

• HRA funds used to offset health insurance deductible

• “Promise to Pay” – this money is available to you only if you need it

• Any unused HRA funds stay with Fuse

• HRAs are funded solely by Fuse (no EE contributions)

• HRAs are not portable and revert back to Fuse upon separation of employment

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Cigna Online

– Register for online access at www.mycigna.com

• View claim history

• View YTD deductible info

• Find a doctor

• Order new ID cards

• Download claims forms

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Employee Contributions

• Employee Monthly Payroll Contribution:

Single Two-Person Family

$75 $200 $320

+$10/mo +$30/mo +$20/mo

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Opt Out Bonus

– If you opt out of Fuse’s health plan AND can provide proof of your other coverage, you will receive:

Eligible for… Bonus (for 12 mo.)

Single $1,000

Two-Person $1,200

Family $1,500

2P / Family but enroll as single $500

*Bonus listed is earned / paid out via payroll each pay period.

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Dental & Vision Insurance

• Self-funded plans managed by Northeast Benefits Management (NBM)– Health plan enrollment = auto-enroll in dental &

vision– If you opt out of health, you can still enroll in

dental & vision– Employees submit expenses online at

www.nbmus.com

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Dental / Vision Reimbursements

SERVICE REIMBURSEMENTPreventive

CleaningsX-Rays

Basic RestorativeFillings

ExtractionsEndodonticsPeriodontics

Major RestorativeCrowns

ImplantsDentures

CosmeticVeneers

Teeth whitening

Single $1,000/yearCouple $2,000/yearFamily $2,500/year

50% up to $1,000 per lifetime per member

DENTAL

100%

80%

50%

NONE

Maximums

Orthodontics

Single $200/year $100/yearCouple $400/year $200/year

MATERIALS (glasses/contacts)

EXAMS

VISION

$200/year per member

$100/year per

Family

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Dental & Vision Contributions

• Employee Monthly Payroll Contribution:

Single Two-Person Family

$10/mo $20/mo $20/mo

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FSA - Unreimbursed Medical

• Flexible Spending Accounts (FSA’s)– Managed by Northeast Benefits Management

(NBM)

– FSA funds can be used to pay for:• OOP Medical expenses • OOP Dental and Vision expenses• Rx co-pays

– $500 can be carried over!

– Contribution limit for 2015 is $2,550 (+$50)

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FSA - Dependent Care

• Dependent Care Account: managed by Northeast Benefits Management (NBM)

– Employees can set aside up to $5,000 of pre-tax pay per year per family to be used for Dependent Care (i.e. child care)

– Submit claims online at www.nbmus.com

– Forfeited by end of year if not used

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Other Insurance Benefits

• Short-Term Disability– For illness, injury or maternity– Pays 66.6% of salary (up to 13 weeks)– Maximum benefit increased to $1,500 per

week

• Long-Term Disability– For illness or injury exceeding 90 days– Pays 60% of salary (max $6K per month)

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2015 Health Insurance Renewal

• Every eligible employee must complete the checklist and applicable forms and return to Laurie by 12/17/14

• All forms and the checklist can be found on the intranet

• You can use Acrobat’s approval stamp; or print & sign, then email

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Q&A

Questions?