DARTMOUTH COLLEGE 2013 BENEFITS AND WELLNESS. Fall 2012 Education Sessions

Transcription

1 DARTMOUTH COLLEGE 2013 BENEFITS AND WELLNESS 1 Fall 2012 Education Sessions

2 AGENDA Benefits at Dartmouth Eligibility Changes for 2013 Other Benefit Info Open Enrollment Wellness Introduction to Cigna Resources Q&A 2

3 KEY MESSAGES The cost of our benefits and the health of the Dartmouth community is a shared responsibility Take advantage of new tools and services Take the time to evaluate your treatment and cost options for health care services Use this opportunity to review all your benefits, including retirement savings Review your Explanation of Benefits forms Keep your personal contact information up to date 3

4 NEW HEALTH PLAN ADMINISTRATOR After a comprehensive request for proposal (RFP) process, Cigna was chosen as the new health plan third party administrator (TPA) beginning in January 2013 The College Benefits Council (made up of faculty and staff) unanimously supported the recommendation Minimal impact on plan members Extensive provider Network No change in member cost structure (deductibles, coinsurance, copayments, max out of pocket) Minimal changes to covered services Will allow greater ways for employees to take a more active role in their health 4

5 BENEFIT ELIGIBILITY Employee Eligibility Employees who are regularly scheduled to work at least 20 hours or more per week Temporary employees are not eligible to participate Eligible Dependents Spouse or Same-Sex domestic partner (w/ proof of legal partnership) Children of covered parents through age 25 Types of Coverage No coverage Single Coverage (Employee only) Two-Person (Employee plus one) Family (Employee plus 2 or more) 5

6 CHANGE IN PLAN NAMES 2012 Anthem BCBS 2013 Cigna BlueChoice POS Open Access Plan 1 Preferred Blue PPO Open Access Plan 2 Indemnity High Deductible Health Plan Open Access High Deductible Health Plan * The Dartmouth College pharmacy benefit manager is CVS Caremark for all three plans in

7 NO CHANGES TO OPEN ACCESS PLAN 1 COST STRUCTURE Cost Structure (In network) 2012 BlueChoice POS 2013 Open Access Plan 1 Preventative Care* Covered at 100% Covered at 100% Copayment Deductibles Coinsurance Out of Pocket Maximum** Prescription Drugs via CVS Caremark $20 PCP $30 Specialist $250 Individual $750 Family 10% Coinsurance $1,000 per individual $3,000 per family $1,250 per individual $3,750 per family 30-day Retail Supply $5/$25/$40 90-day Mail Order Supply $10/$50/$80 $20 PCP $30 Specialist $250 Individual $750 Family 10% Coinsurance $1,000 per individual $3,000 per family $1,250 per individual $3,750 per family 30-day Retail Supply $5/$25/$40 90-day Mail Order Supply $10/$50/$80 * Preventative Care link can be found on the resources page ** Deductible + Coinsurance = Out of Pocket Maximum 7

8 MINOR CHANGES TO OPEN ACCESS PLAN 1 COVERED SERVICES Covered Services 2012 BlueChoice POS 2013 Open Access Plan 1 Network New England National Primary Care Physician (PCP) Requirement Vision Hardware Emergency Room Visit Short Term Rehab Limit (PT, OT, Cognitive, Speech) Chiropractic Coverage Limit Fitness Reimbursement Hearing Aid Coverage Required $40 per year Reimbursement $100 Copay Professional Services NOT included in copay 80 visits per year (PT, OT Cog) 80 visits per year (Speech) Not Required $50 per year Reimbursement $100 Copay Professional Services ARE included in copay 80 days per year (All combined) 20 visits per year 20 days per year $200/year for attending a gym 2 times a wk for 12 out of 20 wks Maximum Allowable Benefit for least expensive service that meets medical needs $200/year for attending a gym 2 times a wk for 10 out of 20 wks Every 3 years $3,000/adult $6,000/<18yrs 8

9 NO CHANGES TO OPEN ACCESS PLAN 2 COST STRUCTURE Cost Structure (In network) 2012 Preferred Blue PPO 2013 Open Access Plan 2 Preventative Care* Covered at 100% Covered at 100% Copayment Deductibles Coinsurance Out of Pocket Maximum** Prescription Drugs via CVS Caremark $20 PCP $30 Specialist $500 Individual $1,500 Family 10% $1,500 per individual $4,500 per family $2,000 per individual $6,000 per family 30-day Retail Supply $5/$25/$40 90-day Mail Order Supply $10/$50/$80 $20 PCP $30 Specialist $500 Individual $1,500 Family 10% $1,500 per individual $4,500 per family $2,000 per individual $6,000 per family 30-day Retail Supply $5/$25/$40 90-day Mail Order Supply $10/$50/$80 9 * Preventative Care link can be found on the resources page ** Deductible + Coinsurance = Out of Pocket Maximum

10 MINOR CHANGES TO OPEN ACCESS PLAN 2 COVERED SERVICES Covered Services Vision Exam Emergency Room Visit 2012 Preferred Blue PPO <18 yrs = 1 exam/year 18+ yrs = 1 exam/two years $100 Copay Professional Services NOT included in copay 2013 Open Access Plan 2 1 exam/year $100 Copay Professional Services ARE included in copay Short Term Rehab Limit (PT, OT, Cognitive, Speech) Chiropractic Coverage Limit Fitness Reimbursement 80 visits per year (All Combined) 80 days per year (All combined) 20 visits per year 20 days per year $200/year for attending a gym 2 times a wk for 12 out of 20 wks $200/year for attending a gym 2 times a wk for 10 out of 20 wks Hearing Aid Coverage Maximum Allowable Benefit for least expensive service that meets medical needs Every 3 years $3,000/adult $6,000/<18yrs (After deductible & coinsurance) 10

11 NO CHANGES TO OPEN ACCESS HIGH DEDUCTIBLE (HD) COST STRUCTURE Cost Structure 2012 Indemnity High Deductible Health Plan 2013 Open Access High Deductible Plan Preventative Care Covered at 100% Covered at 100% Copayment None None Deductibles $2,500 Individual $5,000 Family $2,500 Individual $5,000 Family Coinsurance None None Out of Pocket Maximum $2,500 per individual $5,000 per family $2,500 per individual $5,000 per family Prescription Drugs via CVS Caremark Subject to deductible. Mail Order: Reduced pricing for participating prescriptions. Subject to deductible. Mail Order: Reduced pricing for participating prescriptions. 11 * Preventative Care link can be found on the resources page ** Deductible = Out of Pocket Maximum

12 MINOR CHANGES TO OPEN ACCESS HIGH DEDUCTIBLE (HD) PLAN COVERED SERVICES Covered Services 2012 Indemnity High Deductible Health Plan 2013 Open Access High Deductible Plan Prescription Drug Vendor Short Term Rehab Limit (PT, OT, Cognitive, Speech) Anthem Express Scripts 80 visits per year (All Combined) CVS Caremark 80 days per year (All combined) Chiropractic Coverage Limit 20 visits per year 20 days per year Fitness Reimbursement $200/year for attending a gym 2 times a wk for 12 out of 20 wks $200/year for attending a gym 2 times a wk for 10 out of 20 wks Hearing Aid Coverage Maximum Allowable Benefit for least expensive service that meets medical needs Every 3 years $3,000/adult $6,000/<18yrs (after deductible is met) 12

13 IN NETWORK VS OUT OF NETWORK Cigna has national network of participating providers Providers agree to charge reasonable and customary amounts for services. Cigna agrees to pay When utilizing services outside network - members are subject to higher deductibles/coinsurance as well as provider costs above and beyond reasonable and customary Enhanced benefit over Anthem 13

14 HEALTH PLAN PREMIUMS Dartmouth average premium increase for 2013 is lower than other employers and the national average (2.5% vs 6-8%) The premiums for the Open Access 1 plan are now higher than Open Access 2 plan Example Full time employee with $52,000 annual salary (monthly premiums) Open Access 1 (formerly Blue Choice POS) Open Access 2 (formerly Preferred Blue PPO) High Deductible Health Plan $ diff $ diff $ diff Single (12.84) person (20.99) Family (28.33) Up to $200 in annual wellness incentives will be available in 2013 Use the Employee Medical Plan Cost Estimator to calculate your premiums 14

15 CHANGES TO F.S.A. & H.S.A. JANUARY 1, 2013 Flexible Spending Account (F.S.A.) Maximum Contribution reduced to $2,500 for 2013 (IRS Regulation) No Change to Employer $250 contribution for those making less than $60,000 per year (prorated based on FTE and new hire date) Save your card use year to year Health Savings Account (H.S.A.) Must be on the High Deductible plan $3,250 Maximum Contribution Single $6,450 Maximum Contribution Household $1,000 annual catch-up contribution for those years of age 15

16 OPEN ENROLLMENT October 22 - November 5, 2012 Do I need to Enroll? Highly Encouraged Review benefits and ensure accuracy Make Benefit and coverage changes Enroll in HSA and FSA (Medical and Dependent) accounts (not automatic) Change retirement contributions What if I don t Enroll? You will default to a comparable 2012 plan Medical, Dental, Life, Disability, Long Term Care HSA and FSA (Medical and Dependent) contributions will be $0 16

17 Biometric Screenings ($50)* Health Assessment ($100)* Health Coaching ($50)* Incentives Preventive Screenings Flu Shots Healthy Benefits 17 * Incentives are available to all benefits eligible employees, even if they are not enrolled in a Dartmouth College health plan.

18 WELLNESS EVENT Introduce new services Meet with health partners Meet Health Coaches Highlight existing resources Indoor options Outdoor options 18 Indoor options

19 CIGNA HEALTH CARE Who we are: Cigna is a global health service company, dedicated to helping the people we serve improve their health, well-being and sense of security. Why we do what we do: Our goal is to provide healthcare with proven health and wellness programs targeted to the unique needs of our individual customers 19

20 HOW CAN CIGNA HELP YOU? Full Coverage Preventative Screenings Alerts are sent to you and your doctor if we see or anticipate a gap For example: if you are a diabetic and have not had the appropriate screens Keep your doctor during transitions (for example, if you re new to Cigna or your doctor leaves our network) when you are in the middle of treatment for certain health care conditions 90 day Mental Health providers transition. Services paid at in network. 20

21 HOW CAN I GET INFORMATION ABOUT CIGNA TODAY? Call Cigna s pre-enrollment help line for questions regarding benefits, the network or for help comparing plans (until December 31, 2012) 24/7 Customer Service Call any time day or night, 365 days a year (as of January 1, 2013) More robust website Find a provider Health and Wellness initiatives Manage your claims Provider Nomination form 21 Benefits Forms page:

22 ID CARDS ID Cards will arrive in early December One for each dependent - Maximum of four cards per envelope Receive both Medical and Vision Cards (arrive separately) ID Cards include a Tufts logo What if I don t have my ID card Call Update address with Dartmouth College Payroll Office ( and form) Do not throw away Anthem cards until after January 1,

23 FIND A DOCTOR Click Find a Doctor in orange at the top of the page Choose a doctor, hospital or facility and search by name, specialty or location Next, select your plan: Open Access Plus, OA Plus, Choice Fund OA Plus WITH Carelink Contracted providers will appear 23

24 IMPORTANT INFORMATION Open Enrollment Communications Enrollment Letters will be mailed in mid October Watch your Hinman box (mailed to home address for offcampus staff, Retirees, and those on leave) D2U reminders will be sent regularly Open Enrollment Assistance Sessions One-on-one assistance with Benefits staff for individual Q&A or computer access (10-15 minute sessions) Meeting sites at HR and across campus (no signup required) Ongoing Educational Sessions Available across campus through November 2, Online Video coming soon 24

25 IMPORTANT DATES Wellness Fair: Date: Location: Time: Theme: October 17 th Alumni Hall 10am - 2pm You! Harvesting Health Flu Clinics: Available October 2 nd, 3 rd, 4 th and 17th Sign up at Open Enrollment: 12:00 am October 22 through 11:59 pm November 5 Employee Services Fall Fair: Date: October 31 st Location: Collis Common Ground Time: 10am - 2pm Theme: A Healthier Dartmouth 25

26 TOP 6 THINGS TO REMEMBER 1. Enroll on Flex Online between October 22 November 5 2. New plans/rates take effect January 1, Open Access Plan 1 (POS) now National Network 4. New ID Cards for Medical and Vision arriving early December (sent separately) 5. New Wellness Incentives coming in Mycigna.com coming in January

27 THANK YOU! QUESTIONS? 27