From Community Unit School District 303

Transcription

1 From Community Unit School District 303

2 Medical Plan Options for 2016 D303 and your Insurance Committee are pleased to offer exciting new benefit options for District 303 (D303) will offer only three medical plans. These same three options will be available to all employees who are eligible for medical insurance, regardless of salary Plan Design HMOI PPO CDHP w/ HSA Deductible Single EE+1 Family Out-of-Pocket Maximum Single EE+1 Family Office Visit Copays Primary Care Specialist n/a $1,000 n/a $2,000 $20 $40 $400 $800 $1,200 $4,000 $8,000 $12,000 $25 $50 $1,500 n/a $3,000 $6,000 n/a $12,000 Preventive Care 100% 100% 100% Coinsurance 100% 80% 80% Prescription Drugs (retail) Generic Brand Non-Preferred Brand $10 copay $25 copay $60 copay $10 copay $25 copay $60 copay n/a $10 copay* $25 copay* $60 copay* The CDHP includes a $500 Single/ $1,000 Family employer contribution to your HSA! * All drugs other than approved preventive medications are subject to the deductible. Approved preventive medications are paid at $10/$25/$60 prior to deductible. All other prescription drugs are paid at $10/$25/$60 copays after deductible is met.

3 Medical Contribution Tiers for 2016 Premium contributions will now have four tiers. Employee Only Employee + Spouse Employee + Child(ren) Employee + Spouse + Child(ren) See Insurance Deductions sheet for details.

4 Other Benefits Vision Insurance There will be no changes to the vision plan for Administered through VSP 100% Board paid Dental Insurance There are no changes to the dental plan for 2016 Administered through Delta Dental No rate increase for 2016, see Insurance Deductions sheet for details Life Insurance There are no changes to the life insurance for % Board paid Details on extra benefits from the life insurance carrier are in your open enrollment packet

5 CDHP (Consumer Driven Health Plan)

6 CDH Plan CDHP In-Network Out-of-Network Individual Deductible $1,500 $3,000 Family Deductible $3,000 $6,000 Employer Contribution $500 Single/$1,000 Family Individual Out-of-Pocket Maximum $6,000 $12,000 Family Out-of-Pocket Maximum $12,000 $24,000 Coinsurance 80%* 70%* Preventive Care 100% no deductible 90% no deductible Office Visit 80% after deductible 70% after deductible Emergency Room 80% after deductible 70% after deductible Retail Rx Generic / Preferred / Non-Preferred Deductible then $10/$25/$60 N/A *Specialty retail limited to a 30 day supply Mail Order Rx Generic / Preferred / Non-Preferred Deductible then $20/$50/$120 N/A

7 How the Health Savings Account Works The Health Savings Account (HSA) consists of two parts: 1 Consumer Driven Health Plan (CDHP) 2 The Health Savings Account HSAs must be used with a Qualified High Deductible PPO Plan that does not cover first dollar medical expenses (outside of preventive care / wellness). 3

8 Online Tools and Resources

9 Blue Access for Members SM Go to bcbsil.com and log in to Blue Access for Members via web or mobile. Click Register Now for New Users To register you will need your Identification number on the front your ID card OR you can call the Customer Service number on the back of the card 5

10 Blue Access for Members SM My Coverage includes benefit highlights, spending accounts, as well as deductibles and outof-pocket and copay summaries Access the Provider Finder to locate doctors & hospitals and view cost estimates for a variety of procedures My Health tab links you to health and wellness content, articles, videos, and My Care Profile Quick Links for easy access to Health Assessment, Fitness Program, Member Discounts, or to get an ID card My Claim Activity displays recent claims, or go to the Claims Center for all your claim details Form Finder easier to view and find specific forms for members 6

11 Accessing the Provider Finder To access the Provider Finder, click the Doctors & Hospitals tab in Blue Access for Members SM, then select the Find a Doctor or Hospital button 7

12 Provider Finder Homepage How much will a procedure REALLY cost you? The Provider Finder shows expected out-of-pocket costs for specific procedures* Based on actual benefit plan and BCBS contracted amounts Shows how much deductible / out-of-pocket amounts remain, even spending accounts Quality designations for facilities and physicians Enhanced provider demographics Customizable search, maps and directions Patient reviews on physicians *Cost information available upon log-in for members of PPO / CDHP 8

13 Provider Search Results Compare up to 10 Providers side by side Refine your results by Distance, Rating, Languages, Quality Designations and more Provider Results See what other BCBS members think about a doctor 9

14 Cost Estimate: MRI of the Brain Expected cost range for you and for your employer for this type of MRI Member-specific estimated outof-pocket cost results for each facility 10

15 Cost Estimate Breakdown 11

16 Cost Estimate Breakdown 12

17 Invest in your health with a Health Savings Account

18 Health Savings Account Today we ll be answering these common HSA questions: What is it? What can it be used for? Why should I have one? Who is eligible? How does it work? How easy is it to manage?

19 What is an HSA? A personal savings account for your medical expense Paired with a highdeductible health plan Financial account owned by you Pays for current and future medical expenses

20 Why should I have one? Health Savings Accounts have special advantages

21 Who is not eligible for the HSA? Any medical coverage outside of qualified HSA Dual Coverage HSA participant covered by another plan not HSA compatible Medicare Enrollment - Employee can opt out of Medicare A & B to retain eligibility Tri-Care or VA Benefits-limited eligibility Flexible Spending Account Employee or spouse enrolled in Medical FSA For D303 employees enrolling in an HSA, any rollover FSA funds from 2015 will be moved into a limited purpose account for 2016 (dental and vision only) IMPORTANT: If you are enrolling in the CDHP but are not eligible for the HSA, please fill out and submit a waiver to Lonnie Gridley. It is your responsibility to follow IRS guidelines.

22 What can an HSA be used for? Distribution is tax-free for qualified medical expenses Medical Services, procedures and treatments Diagnostic services Drugs Examples of qualified medical expenses under Section 213(d) of the IRS code include: Consult your tax advisor for items not on the list Prescriptions Over-the counter (with DR RX) Vision/Hearing Dental Long-term care insurance (age based) Medicare Coverage Health Care Coverage when receiving unemployment compensation or COBRA coverage

23 How does an employee contribute? Employers and employees can contribute, with all funds immediately vested. Employer contributions belong to you and are not taxable. Pretax contributions, through payroll deduction, can be changed at any time. Post-tax contributions are an above-the-line deduction. Post-tax contributions can be made up to the date tax returns are due.

24 How does it work? Maximize your contributions and your savings potential 2016 Maximum Contributions: $3,350 Employee-only coverage $6,750 Family Coverage 55+ Catch-Up Contributions: $1,000

25 How do Employees pay claims at SelectAccount? We make it easy for employees to access their HSA funds HSA Debit Card - Free card for employee - Additional cards available for no cost Out-of-pocket with online reimbursement Pay the Provider online bill payment

26 How does it work A few things to know about using your HSA funds Only withdrawals for qualified medical expenses are tax free. Non-medical penalized at 20% Expenses must be incurred after HSA is established. Expenses are reimbursed up to the HSA balance No time limit on reimbursement requests

27 Online Member Service Center Employees can manage the account easily with SelectAccount.com View account 24/7 via PC, laptop, tablet or smart phone. Pay Health Care Providers Request reimbursements for out of pocket expenses Check Balance Make contributions View account history Request additional debit cards, add/change beneficiaries

28 e-vault Electronic storage of receipts and EOB s Match receipts with previously reimbursed expenses Store to check balance of unreimbursed expenses Sort by date, tax year, amount or name Available via 24/7 Member Service Center Upload receipt on the go via Smart Phone

29 HSA Investment Options Eligible employees can buy-up to the Investment Product for $1.50 per month. Basic Investment- 26 Mutual Funds Available Managed through SelectAccount Member Service Center Eligible once HSA balance exceeds $1,000. Brokerage Account Over 2500 mutual funds, as well as stocks, bonds and other investments via Charles Schwab Services. Managed at Schwab.com Eligible once HSA balance exceeds $10,000

30 We re here to help Our expert, friendly service team is here to answer employees questions Monday thru Friday 7 a.m. to 7 p.m. CST CustomerSolutions@SelectAccount.com

31 Q&A