OPEN ENROLLMENT 2012

OPEN ENROLLMENT 2012BELLARMINE EMPLOYEES’

OPEN ENROLLEMENT 2013

Presented By: Laura Kuczenski

925-385-5305; [email protected]

mailto:[email protected]

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BENEFITS

• Medical• Blue Shield of California• Kaiser

• Dental – Assurant• Vision – VSP• Life/Disability – Sun Life• Long Term Care – Unum• FSA – Pension Dynamics• HSA – Sterling

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WHAT IS OPEN ENROLLMENT?

OPEN ENROLLMENT

Open Enrollment is a once-a-year opportunity to make election changes

Change plans Add or drop coverage for yourself Add or drop coverage for your dependents

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MID-YEAR QUALIFYING EVENTS

What changes can I make outside of Open Enrollment?

The only ti me you can make an electi on or enrollment change outside of your open enrollment period is if you experience an eligible qualifying event as defi ned by the IRS.

Common examples of qualifying events include, but are not l imited to, the following:

Marriage Divorce or legal separationBirth or adoptionGain or loss of coverage

OPEN ENROLLMENT

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IMPORTANT DATESMEDICAL COVERAGE

• 11/12/12 to 12/17/12 - Open enrollment • 1/1/2013 – Your plan changes become effective • 1/1/13 – 12/31/13 – The “Plan Year”

IMPORTANT FACTS• Deductibles and out of pocket maximums are the Plan

Year (aka Calendar Year)• Dependent children covered up to age 26

• They are then COBRA eligible

• Opt-out medical incentive: $166.67 per month • With proof of other medical coverage

OPEN ENROLLMENT

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• Largest nationwide network

• Not-for-profit organization

• 24/7 nurse line• Access to free programs

including MyHealth Coach, Future Moms, and more

• Can choose any doctor; however, in-network doctors will provide greater savings

• Email your doctor, online lab results

• Access to free programs including health management, weight loss support, quitting smoking

• Doctor must be in Kaiser community

• All Kaiser doctors have access to your medical records

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• No plan changes; however, some carrier- mandated benefit changes• Carriers required certain changes to plan designs

across the board for all fully insured clients. • Bellarmine did not have any say in the changes

• Selected Carrier Mandated changes highlighted in red• This presentation is an overview. Complete “Benefit

Modification” summaries can be found on the website

MEDICAL RENEWAL

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Plan Features In-Network Non-Network

Deductible Per Member Per FamilyOut of Pocket Max Per Member Per Family

$0$0

$1,000$3,000

$500Maximum of 3

$3,000$9,000

Preventive Care Routine exam, screenings $0 Not covered

Office / Specialist Visits $10 / $10 30%

Diagnostic Lab & X-ray $10 30%

Coinsurance 10% 30%

Hospital Services $200/day for 5 days 30%

Emergency Services $100 copay + 10%

Prescription Medication Tier 1 Tier 2 Tier 3 Tier 4

$10$20$35

30%

25% of billed amount plus copays

BLUE SHIELD – PREMIER PPOMEDICAL PLAN DESIGNS

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BLUE SHIELD – SPECTRUM PPOMEDICAL PLAN DESIGNS


Deductible Per Member Per Family

$500$1,500

Out of Pocket Max Per Member Per Family

$2,000$6,000

$5,000$15,000

Preventive Care Routine exam, screenings $0 Not Covered

Office Visits $15 30%

Diagnostic Lab & X-ray $15 30%

Hospital Services 10% 30%

Emergency Services $100 + 10% after deductible


$10$20$35

30%

25% of billed amounts plus copays

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$2,250$4,500


$3,000$6,000

$6,000$12,000

Preventive Care Routine exam, screenings $0 Not Covered

Office Visits 20% after deductible 50% after deductible

Diagnostic Lab & X-ray 20% after deductible 50% after deductible

Hospital Services $100 + 20% after deductible

50% after deductible

Emergency Services $100 + 20% after deductible


After deductible$10$25$40

30%

After deductible

25% of billed amounts plus copays

BLUE SHIELD – 2250/4500 HSAMEDICAL PLAN DESIGNS

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HSA BASICS WHAT IS AN HSA?

Individual Tax-favored health savings account

You own your account, and funds roll over each year – NO “use it or lose it” rules FSA has a “use it or lose it” policy

WHO IS ELIGIBLE FOR AN HSA? Must be enrolled in qualifying High Deductible Health Plan such as Kaiser and Blue Shield HSA

Not covered under any other health insurance

Not enrolled in Medicare or receiving VA benefits

Not another person’s dependent

MAXIMUM CONTRIBUTIONS 2012: $3,100 individuals / $6,250 families

2013: $3,250 individuals / $6,450 families

For Both Years: $1,000 “catch-up” contributi on for individuals over 55 years of age

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HSA - STERLING

STERLING HSA Employees must open an HSA account through Sterling to receive direct contributions from

Bellarmine, and to set aside pre-tax dollars through payroll

WHAT DOES THE COMPANY CONTRIBUTE?

NO CHANGE FROM 2012

Blue Shield of CA HSA: Single: $242

Employee Family: $485

Kaiser HSA: Single: $900

Family: $1,800

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KAISER HMO $10MEDICAL PLAN DESIGNS

Plan Features In-Network Only

DeductibleOut of Pocket Max Per Member Per Family

none

$1,500$3,000

Preventive Care Routine exam, screenings $0

Office Visits $10

Specialist Visits $10

Diagnostic Lab & X-ray No charge

Hospital Services No charge

Emergency Services $50 copay (waived if admitted)

Prescription Medication Generic and Brand $10

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Plan Features In-Network Only


$1,500$3,000


$1,500$3,000

Preventive Care Routine exam, screenings $0

Office Visits 0% after deductible

Diagnostic Lab & X-ray 0% after deductible

Hospital Services 0% after deductible

Emergency Services 0% after deductible

Prescription Medication $0 after deductible

KAISER – HSAMEDICAL PLAN DESIGNS

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NEW PREVENTIVE CARE GUIDELINES FOR WOMEN COVER THE

FOLLOWING SERVICES (COVERED AT 100% WITHOUT COST

SHARING) Well-women visits

Gestational diabetes screening

HPV DNA Testing for women 30 and older

Sexually Transmitted infection counseling; HIV screening and counseling

FDA approved contraception methods and counseling

Breastfeeding support, supplies, and counseling

Domestic Violence support, supplies, and counseling

FOR ADDITIONAL DETAILS www.healthcare.gov/law/provisions/preventive/index.html

PREVENTIVE CARE FOR WOMEN

http://www.healthcare.gov/law/provisions/preventive/index.html

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DENTAL PLAN DESIGN

DEDUCTIBLE $50 individual / $150 family

COVERAGE ( in-network/out-of-network) Diagnostic and Preventive (deductible waived): 100% / 100%

Basic (ex: Fillings, simple extractions): 90% / 80%

Major (ex: crowns, dentures): 60% / 50%

Orthodontia: 50% (child-only)

PLAN MAXIMUMS $1,000 calendar year max. per person

$1,000 orthodontia lifetime max.

BELLARMINE PAID

DENTAL “ACTIVE” PPO

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VSP SIGNATURE NETWORK Only available to Blue Shield members

Kaiser members have their own vision plan

COPAYS $20 exam copay

Lenses: $20 Copay

Frames: Up to $120 + 20% of additional costs

Contact Lenses: Up to $120 for contact and contact lens exam.

SERVICE FREQUENCIES Exams: every 12 months

Lenses (for glasses or contacts): every 24 months

Frames: every 24 months

BELLARMINE PAID

VISIONVISION PLAN DESIGN

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LIFE AND DISABILITY

LIFE AND AD&D INSURANCE Insured by Sun Life Financial

2x Salary to $200,000

Benefits reduction: 65% at 70 years of age

50% at 74 years for age

BELLARMINE PAID

LONG TERM DISABILITY Insured by Sun Life Financial

Benefit is 66.67% of pre-disability earning to $8,000 per month

90-day elimination period

BELLARMINE PAID

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LONG-TERM CARE BASE PLAN

Insured by Unum

3-year benefit duration

$3,000 monthly facility benefit; 70% Residential Care facility

$36,000 life-time benefit

BELLARMINE PAID

BUY UP OPTIONS – OUTSIDE OF INITIAL ELIGIBILITY Open to you and your family

ALL buy-up requires medical questi onnaire (See HR for the forms)

Increase monthly benefit amount

Increase lifetime maximum

Increase benefit duration (6 years or unlimited)

Add inflation protection

EMPLOYEE PAID

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HEALTH CARE FSA – UP TO $2,500 ANNUALLY IRS CHANGED THE MAXIUM FROM $10,000 IN 2012 TO $2,500 IN 2013

LIMITED PURPOSE FSA – UP TO $2,500 ANNUALLYIRS CHANGED THE MAXIUM FROM $10,000 IN 2012 TO $2,500 IN 2013

DEPENDENT CARE FSA – UP TO $5,000 ANNUALLY

FSAs help you pay eligible healthcare and dependent care expenses on a pre-

tax basis (lowering your overall taxable income).

If you are enrolled In The Anthem HMO, PPO, or Kaiser HMO, then you may

enroll in a full FSA

IF YOU HAVE AN HSA Account, you may only enroll in a Limited Purpose FSA

(Dental and vision expenses)

Dependent Care FSA is not affected by your medical plan

U S E- I T-O R -LO S E- I T RU L E : U N U S E D DO LLA RS A R E N OT R E T U R N E D TO YOU !

FLEXIBLE SPENDING ACCOUNTS (FSA)

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Examples of Eligible ExpensesHealth Care Limited Purpose

• Hearing services, including hearing aids and

• Batteries• Prescription and office visit copays• Dental and orthodontia

• Dental and Orthodontia• Hearing services not covered by your

medical plan• Lasik Surgery• Other vision expenses

Dependent Care

• The cost of child or adult dependent care (must be tax dependent)• Nursery schools and preschools (excluding kindergarten)• The cost for an individual to provide care either in or out of your house

FLEXIBLE SPENDING ACCOUNTS

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CONTRIBUTION STRATEGY

EMPLOYEE CONTRIBUTIONS

BLUE SHIELDPremier PPO

$0/$500

2012 EE/PP

2013 EE/PP

2012 EE Cost/Yr

2013 EE Cost/Yr

Single Employee $168.22 $177.04 $4,037 $4,249

Employee + 1 Dependent $463.55 $485.33 $11,125 $11,648

Employee + Family (2 or

more)$641.32 $671.91 $15,392 $16,126

Numbers may vary due to rounding

BLUE SHIELDSpectrum PPO

$500/$1,000

2012 EE/PP

2013 EE/PP

2012 EE Cost/Yr

2013 EE Cost/Yr

Single Employee $124.66 $131.87 $2,992 $3,165



more)$508.02 $533.66 $12,192 $12,808


BLUE SHIELDHSA

$2,250/$4,500

2012 EE/PP

2013 EE/PP

2012 EE Cost/Yr

2013 EE Cost/Yr

2012Paid by ER to HSA

2013 Paid by ER to HSA

Single Employee $22.35 $25.41 $536 $610 $242 $242

Employee + 1 Dependent $151.57 $161.04 $3,638 $3,865 $485 $485


more)$184.31 $197.20 $4,423 $4,733 $485 $485


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EMPLOYEE CONTRIBUTIONS

KAISERHMO $0 2012 EE/PP 2013 EE/PP 2012 EE

Cost/Yr2013 EE Cost/Yr

Single Employee $6.26 $6.37 $150 $153


Employee + Family (2 or more) $77.58 $79.58 $1,862 $1,910


KAISER HSA$1,500/$3,000

2012 EE/PP

2013 EE/PP

2012 EE Cost/Yr

2013 EE Cost/Yr

2012Paid by ER to HSA

2013 Paid by

ER to HSA

Single Employee $14.72 $24.58 $353 $590 $900 $900

Employee + 1 Dependent $96.97 $118.58 $2,327 $2,846 $1,800 $1,800


more)$70.39 $99.95 $1,689 $2,399 $1,800 $1,800


CONTRIBUTION STRATEGY

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EMPLOYEE BENEFITS WEB PORTAL

FILICE HAS DESIGNED A CUSTOMIZED WEBSITE THAT

ALLOWS EMPLOYEES AND DEPENDENTS TO ACCESS

INFORMATION AS NEEDED. Plan Overviews

Physician Directories

Group Numbers and Carrier Contact Information

HR Forms and Required Postings

Account Manager Contact Information

www.filice.com/benefits/bcp

OUR BROKER – FILICE INSURANCE

http://www.filice.com/benefits/bcp

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All electi ons wil l automati cally transfer. No action needed if you are not changing your medical; however: All

medical waivers must be accompanied by a recent copy of your medical

card to HR. Incentive payments will not begin unti l a copy of the medical

card is received.

FSA AND HSA BENEFITS MUST BE RENEWED WITH HR All changes must be made by December 17, 2012.

All changes will go into effect January 1, 2013.

WHAT NOW?

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OPEN ENROLLMENT INSTRUCTIONSO P E N E N R O L L M E N T B E G I N S

M o n d a y, N o v e m b e r 1 2 , 2 0 1 2 t h r o u g h D e c e m b e r 1 7 , 2 0 1 2

You wil l be able to access your benefi ts and change them, if you desire, on the ADP website. Remember to reenroll in

your F lexible Spending and HSA Accounts! To access your account:

1. Go to this URL: htt ps://portal.adp.com

2. Enter your User ID: (your fi rst initi al and last name)@bellarmine

3. Enter the password you created when you registered

If you forgot your password, hit the “Forgot Password” and it wil l take you through the steps to setup a new password.

I f that doesn’t work, please contact Christi ne Carbone to help you get into the site.

At the top you wil l see tabs.

1) Cl ick on the “Benefi ts” tab

2) A dropdown menu wil l appear

3) Scrol l down to “Review/Change Benefi ts”

4) You wil l then be asked to select one of the fol lowing:

• Walk me through the process

• I know what changes I want to make.

• Review my benefits coverage.

5) CONGRATULATIONS!! You are now in “Open Enrol lment ”. Make your desired changes now.

6) If you have any questi ons or need help, don’t hesitate to cal l (x228) or email Christi ne

https://portal.adp.com/

https://portal.adp.com/

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YOUR QUESTIONS?

?You can contact your Fi l ice

Account Manager:

Laura Kuczenski

laura@fi lice.com 925-385-5305

mailto:[email protected]

OPEN ENROLLMENT 2012

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