Saint Louis University Employee Benefits 2015 Annual Enrollment Benefits Overview—Coverages Offered Medical/Prescription Drug New this year! (Non-Union Employees Only) Vitality Wellness Program Voluntary Vision Voluntary Dental Voluntary Accident Health Savings Account Flexible Spending Accounts Basic Term Life and AD&D Voluntary Term Life Voluntary AD&D Long Term Disability Long Term Care Business Travel Accident Medical/Prescription Drug Benefits Annual Enrollment 2015 Highlights Effective January 1, 2015 Medical - UnitedHealthcare Plus Plan: Medical and Prescription drug copays will accumulate towards the out-of-pocket maximum in the Plus Plan QHDHP Plan No plan changes Health Savings Account The Vitality™ Wellness Program Participants save on medical premiums and earn rewards! Health screenings and HRA completion are needed to receive wellness discount If covering your spouse, both must complete requirements Deadline: November 30 Prescription Drug – Express Scripts No plan change to prescription drug benefits Network continues to include Walgreens and Dierbergs 2015 Medical Plan Options Plus Plan SLUCare In-Network QHDHP Plan Out-ofNetwork SLUCare In-Network Out-ofNetwork Non-Embedded: (One member can satisfy entire family deductible) Deductible Individual $0 $500 $750 $1,500 $1,500 $3,000 Family $0 $1,000 $1,500 $3,000 $3,000 $6,000 Coinsurance 0% 10% 40% 0% 10% 40% Non-Embedded: (One member can satisfy entire family OOP Max) Out-of-Pocket Maximum (includes deductibles and all copays) Individual $1,500 $1,500 $4,750 $1,500 $3,000 $6,000 Family $3,000 $3,000 $9,500 $3,000 $6,000 $12,000 10% after ded. 40% after ded. 0% after ded. 10% after ded. 40% after ded. Physician Office Visits Primary Care $10 copay Specialist Care $20 copay Preventive Care 100% 100% 100% 100% 100% 100% N/A 10% after ded. 40% after ded. N/A 10% after ded. 40% after ded. N/A $100 copay $100 copay N/A 10% after ded. 10% after ded. N/A $50 copay $50 copay N/A 10% after ded. 40% after ded. Inpatient Hospital Emergency Room Urgent Care Center 2015 Pharmacy Plan Options Plus Plan QHDHP Plan Express Scripts Express Scripts Express Scripts Express Scripts Retail Mail Order Retail Mail Order (34-day supply) (90-day supply) (34-day supply) (90-day supply) Tier 1 $8 $16 Medical Deductible and Coinsurance Tier 2 $30 $60 Medical Deductible and Coinsurance Tier 3 $50 $100 Medical Deductible and Coinsurance Tier 4 20% to $150 N/A Medical Deductible and Coinsurance Preventive Medications Priced according to the tier in which they fall Covered at 100%, no copay or deductible Under the QHDHP, certain preventive, or “maintenance,” medications are covered at 100%... No deductible or coinsurance! 2015 Cost Sharing No change to rates!!! Premium has remained the same for 3 years! Wellness Incentive remains at $50 for employee only coverage and an additional $25 for spouse coverage (all or nothing discount) Plan Monthly Premium Deductions With Monthly Wellness Discount Plus Plan Employee Only $143.79 $93.79 Employee and Spouse $386.97 $311.97 Employee and Child(ren) $332.25 $282.25 Family $520.66 $445.66 QHDHP Plan Employee Only $79.64 $29.64 Employee and Spouse $252.24 $177.24 Employee and Child(ren) $210.36 $160.36 Family $328.20 $253.20 Plus Plan – Employees earning up to $33,000 Employee Only $50.00 $0 Employee and Spouse $293.18 $218.18 Employee and Child(ren) $238.46 $188.46 Family $426.87 $351.87 2015 Cost Sharing Bi-Weekly Premiums Plan Bi-Weekly Premium Deductions With Bi-Monthly Wellness Discount Plus Plan Employee Only $66.36 $43.28 Employee and Spouse $178.60 $143.98 Employee and Child(ren) $153.35 $130.27 Family $240.30 $205.68 QHDHP Plan Employee Only $36.76 $13.68 Employee and Spouse $116.42 $81.80 $97.09 $74.01 $151.48 $116.86 Employee and Child(ren) Family Plus Plan – Employees earning up to $33,000 Employee Only $23.08 $0 Employee and Spouse $135.31 $100.70 Employee and Child(ren) $110.06 $86.98 Family $197.02 $162.40 Health Savings Account Annual Enrollment 2015 Health Savings Accounts Health Savings Accounts (HSAs) are designed to help you save and pay for your healthcare now and when you retire Triple tax savings: Put money in pre-tax Grow your savings tax free Pay for qualified medical expenses income tax free Account is always yours HSA Eligibility for Account Holders only You are eligible to open and contribute to an HSA if you: Are covered by a Qualified High Deductible Health Plan (QHDHP) Are not covered by any other health plan that is not a QHDHP Are not enrolled in Medicare, Medicaid, or TRICARE Have not received VA benefits within the past 3 months Are not claimed as a dependent on someone else’s tax return Are not covered by a Health FSA (Must have $0 in your Health FSA before contributing to an HSA) If you don’t meet one of these eligibility requirements, you can still enroll in the QHDHP plan, you just cannot open and contribute to a Health Savings Account HSA Contributions 2015 Maximum Contribution Limit 2015 IRS Maximum SLU Seed Money Individual $3,350 $250 Family $6,650 $500 * 2014 Limits: $3,300 for Individual, $6,550 for Family IRS maximum reflects a combined employer + employee contribution 55+ can fund an additional $1,000/year; “catch-up” contribution Please note SLU will only put seed money into an OptumHealth administered HSA. If you choose to go to a financial institution of your choice, then you will not receive the seed money. HSA must be established by November 30 in order to receive seed money on January 1 Funds must physically be in your account before disbursements can be made Any money remaining in the account at the end of the calendar year rolls over into the next year Taking Money OUT of an HSA Issues in Distributions Reimbursement of expenses for employee, spouse and Tax Code dependents are tax free Expense must be incurred on or after the date the HSA was established Qualified expenses include: Health, dental and vision expenses COBRA premiums Medicare premiums Qualified long-term care premiums Retiree health insurance after age 65, but not Medigap/Supplement plans Other withdrawals are taxable Income tax, plus… Subject to 20% excise tax if withdrawn prior to age 65 After you turn 65, or enroll in Medicare, you may withdraw money for non medical purposes without a penalty. The withdrawal is treated as retirement income and is subject to normal income tax. It is important to save your receipts in case you are audited by the IRS Account is between you and the IRS; OptumHealth bank does not substantiate your claims HSA & FSA Participation IRS guidelines prohibit participants from contributing to a Health Care FSA and an HSA at the same time Spouses are ineligible to participate in their employer’s Health Care FSA Ok if a Limited FSA – used for dental and vision expenses only In order for you to fund an HSA on January 1, there must be a $0 balance in your Health Care FSA on December 31 You can still enroll in the benefit plan, but cannot contribute to an HSA account Making Deposits Payroll Deduction Arrange for an automatic payroll deduction into your account Mail a Check Make a deposit at any time on OptumHealth from your checking or savings account e-Contribute Arrange a regular electronic transfer from an account at another financial institution Access Your HSA Funds Use your UnitedHealthcare Health Savings Account Debit MasterCard® Sign up for automatic bill pay and online banking Use HSA checks Pay with personal funds and reimburse yourself from your HSA myuhc.com Benefit summaries Deductible accumulator Treatment cost estimator Check statements Pay bills to health care providers Update personal information Learn about QHDHPs and HSAs HSA calculators Additional Programs UnitedHealthcare: Diabetes Prevention and Control Pre-diabetics work with YMCA lifestyle coaches to prevent the progression Diabetics work with Shop N’ Save pharmacists face-to-face to help control and improve prescription compliance, set goals, and review lab work Diabetes Health Plan Members incentivized to comply with recommended Medical and Rx guidelines Plus Plan: No office visit or pharmacy copays for diabetes-related eligible expenses Available only when using SLUCare physicians Vitality Annual Enrollment 2015 www.powerofvitality.com Earn points by: Review and activate your personal health goals Update or confirm your email contact information Complete an online Course to learn about a health topic Complete a Vitality Check™ biometric screening with a Vitality partner Schedule Healthy Habits and Preventive Screenings Track your workouts using a Vitality-approved fitness device Sign up at a Partner Health Club Get CPR or first aid certified Once you build up your points, go spend them! Rewards in the Vitality Mall: Amazon Gift Cards Hotel discounts to Hyatt iTunes gift cards Movie theater ticket vouchers Fitbits, Fitbugs, Garmin, and Polar devices Charity Please note: This list does not cover the program in its entirety. Please refer to the web site for complete program activities, rules and details. Voluntary Dental Benefits Annual Enrollment 2015 Voluntary Dental Benefits Coverage will remain with Delta Dental Choose among two dental plan options Both plans include Delta’s PPO and Premier dentists Option 1: Flex Plan No benefit changes Last year the maximum was increased from $1,000 to $1,500 Option 2: Basic Plus No benefit changes Combination of previous Basic Plus and Basic Plan Both in and out of network benefits Voluntary Dental Plan—Delta Dental Flex Option Basic Plus PPO Network Out-of-Network PPO Network Only Out-of-Network Individual $50 $50 $25 $25 Family $150 $50 $75 $75 $1,500 $1,500 $1,000 $1,000 0% no deductible 0% no deductible 50% no deductible 30% after deductible 30% after deductible 65% after deductible 40% after deductible 60% after deductible 60% after deductible 80% after deductible $1,000 $1,000 $1,000 $1,000 50% For adults and children to age 26 60% For adults and children to age 26 50% For children to age 19 only 75% For children to age 19 only Deductible Calendar Year Maximum Per person Preventive Care (Member Responsibility Shown) 0% no deductible Basic Restorative Care ( Member Responsibility Shown) 10% after deductible Major Restorative Services (Member Responsibility Shown) Orthodontia Lifetime maximum (per person) Orthodontia 2015 Dental Contributions Flex Basic Plus Single $36.01 $21.07 Two-person $70.49 $40.52 Family $120.69 $72.60 Single $16.62 $9.72 Two-person $32.53 $18.70 Family $55.70 $33.51 Monthly Bi-Weekly Voluntary Vision Benefits Annual Enrollment 2015 Voluntary Vision Benefits New benefit this year! (Non-Union employees only) Offered through Vision Service Plan (VSP) Plan includes benefits for eye exam, frames, contacts, etc. In-Network vs. Out-of-Network In-Network = no claim forms to complete Out-of-Network = must submit claim form for reimbursement VSP.com Find a provider Network: Choice Register and review benefit information Discounts available Print an ID card (not necessary to use benefits) Plan is 100% employee paid Voluntary Vision Plan—VSP Vision Plan In-Network Out-of-Network $10 copay Up to $45 allowance Single $10 copay Up to $30 allowance Bifocal $10 copay Up to $50 allowance Trifocal $10 copay Up to $65 allowance $150 allowance for a wide selection of frames; $170 allowance for featured frame brands; 20% on the amount over your balance Up to $70 allowance $150 allowance for contacts; including the contact lens exam (fitting and evaluation) Up to $105 allowance Exam Wellvision Exam Lenses Frames Contacts (in lieu of glasses) Frequency Exam/Lenses/Contacts (in lieu of glasses) Frames Every calendar year Every other calendar year 2015 Vision Contributions Vision Plan Monthly Employee Only $7.02 Employee and Spouse $12.76 Employee and Child(ren) $13.38 Family $20.33 Bi-Weekly Employee Only $3.24 Employee and Spouse $5.89 Employee and Child(ren) $6.18 Family $9.54 Voluntary Accident Benefits Annual Enrollment 2015 Voluntary Accident Benefits New benefit this year! (Non-Union employees only) Offered through Voya Financial (formerly ING) Plan reimburses expenses that occur due to an accident Coverage is guarantee issue – no health questions asked No “Network” When you have an expense, you must submit a claim form; reimbursement will then be mailed as a check 24-hour coverage – accidents on or off the job are eligible Plan is 100% employee paid Voluntary Accident Plan—Voya Below is a sample list of benefits, it does not include all the benefits available under the policy. Service Accident Hospital Care Surgery (open abdominal, thoracic) Hospital Confinement Coma (14 or more days) Benefit Amount Common Injuries – Dislocations $1,200 $250/day up to 365 days $6,000 Follow-Up Care Medical Equipment Service Benefit Amount Hip Joint $2,400/$4,800 Knee $1,200/$2,400 Shoulder $360/$720 Common Injuries – Fractures $120 Hip $1,800/$3,600 Physical Therapy $30/treatment (6 max) Leg $960/$1,920 Prosthetic Device $6,000 Emergency Care Ground Ambulance Transport $120 Air Ambulance Transport $600 Emergency Room Treatment $180 Common Injuries Burns, Laceration, Torn Knee Cartilage, Paralysis, Tendon/Ligament/Rotator Cuff Varies Ankle $360/$720 Kneecap $360/$720 Nose $120/$240 Other Benefits Wellness Benefit (completion of health screening test) $100/employee or spouse $50/child (max of 4) Sickness Hospital Confinement Benefit $100/day for employee or spouse $75/day for children 2015 Accident Contributions Accident Plan Monthly Employee Only $24.74 Employee and Spouse $41.90 Employee and Child(ren) $39.62 Family $56.78 Bi-Weekly Employee Only $11.42 Employee and Spouse $19.34 Employee and Child(ren) $18.29 Family $26.21 Flexible Spending Accounts Annual Enrollment 2015 Flexible Spending and Dependent Care Accounts Administration will remain with ConnectYourCare You must make a new election for the 2015 plan year; current elections cannot be carried forward Debit card allows direct payment Eases payment, but does not substantiate claims – receipts may still be needed! Use at authorized vendors (medical facilities, hospitals, pharmacies, etc.) Remember if you are electing the QHDHP plan and open an HSA, the IRS requires your Health FSA balance to be $0.00 on January 1, 2015 before contributing to an HSA Flexible Spending and Dependent Care Accounts Due to health reform, annual maximum for the Health FSA will be remain at $2,500 Annual maximum for the Dependent Care Account will remain at $5,000 ($2,500 if married and filing separate returns) For the Health FSA Total election amount less previous reimbursements is available at the time of transaction For the Dependent Care FSA Only the cash balance in your account is available at the time of transaction You cannot roll over unused balances from one year to the next Use it or lose it rule applies Eligible Medical FSA Expenses Copays, coinsurance and deductibles for medical, prescription and dental plans Eye exams, contacts and eyeglasses Laser eye surgeries Hearing aids Over-the-counter medical supplies Bandages, splints, contact lens solution, etc. Over-the-counter medical medications must be accompanied by a prescription Insulin Some expenses not covered by your medical plan Annual Enrollment 2015 2015 Annual Enrollment Plan elections are binding for the 2015 plan year, unless you experience a qualifying life event: Marriage Birth/adoption Divorce Death Change in employment status Change in dependent status Life status changes allow you to make benefit election changes The Benefits Department must be notified within 31 days of life change 2015 Annual Enrollment Enrollment season is November 1 through 30 If making changes, do so through Banner Self-Service Current medical and dental elections will carry forward Must actively enroll in vision and accident plans, if interested New and existing HSA, Dependent Care and Health FSA participants will need to make an election for 2015. Current deductions will not carry forward. New HSA participants will also need to establish an OptumHealth bank account by November 30 in order to receive seed money Update beneficiary information if necessary All enrollment elections must be completed online no later than Sunday, November 30, 2014 Benefits Office will be closed Thursday, November 27 and Friday, November 28 Contact [email protected] or [email protected] with questions! Questions?