JCPS-HEALTH INSURANCE OPEN ENROLLMENT 2015-16
Changes for FY16 Changes in Board Contribution NONE!!! Changes in Employee Contributions NONE!!! Changes in Dependent Contributions NONE!!! Changes in Plan Benefits NONE!!!
Open Enrollment Open Enrollment May 8 th May 18 th Online Enrollment through Bswift new online benefits system Everyone must complete OE elections Even if you are declining health insurance Even if you are planning to leave the district Last check pays for the next month s insurance Example: if your last check is in August, your employee insurance is in place until Sept 30.
Open Enrollment Must log-in to Bswift to make 2015/16 benefit plan elections. Enrollment Assistance @ Dix Rd Center May 8, 6:00am 10:30am May 11, 12:30pm 4:30pm May 12, 6:00am 12:00pm May 15, 12:30pm 4:30pm Deadline to complete OE: MAY 18 th
3 Health Insurance Choices Base Plan $1,000 Individual/$2,000 Family Deductible 80% Co-Insurance after deductible $3,000 Ind/$6,000 Family Max Out of Pocket (MOOP) Co-Pays DO NOT apply to MOOP Co-Pays CONTINUE after MOOP is reached $10/$30/$50/$75-$125 Drug Card $25/$35 Primary/Specialist Office Visit Co-Pay Employee-Only Monthly Premium $30 With Wellness/$60 Without Wellness
3 Health Insurance Choices Buy-up Plan $500 Individual/$1,000 Family Deductible 90% Co-Insurance after deductible $1,500 Ind/$3,000 Family Max Out of Pocket (MOOP) Co-Pays DO NOT apply to MOOP Co-Pays CONTINUE after MOOP is reached $10/$30/$50/$75-$125 Drug Card $25/$35 Primary/Specialist Office Visit Co-Pay Employee-Only Monthly Premium $75 With Wellness/$105 Without Wellness
3 Health Insurance Choices Health Savings Account $1,500 Individual/$3,000 Family Deductible 100% Co-Insurance after deductible $3,000 Ind/$6,000 Family Max Out of Pocket (MOOP) Co-Pays DO apply to MOOP (the only costs after Ded) Co-Pays STOP after MOOP is reached $10/$30/$50/$75-$125 Rx Card-Only After Ded. $25/$35 Primary/Specialist Office Visit Co-Pay- Only After Deductible Employee-Only Monthly Premium $0 ($20 in H.S.A.) W/Wellness/$10 W/out Wellness
Health Savings Account Required to have a High Deductible Health Plan (HDHP) Our plan has $1,500 deductible Only covered costs prior to meeting deductible are for preventative care Pay actual discounted costs for all care and Rx instead of co-pays After reaching the deductible 100% Co-Insurance vs. 90% Buy-up and 80% Base Co-pays exactly like the other 2 plans kick in.
Health Savings Account $3,000 Max Out of Pocket - MOOP Only costs after $1,500 deductible are Co-pays Co-pays stop after MOOP in HSA but they continue in Base and Buy-up Co-pays count toward MOOP in HSA but they do not in Base or Buy-up Balances in H S A are yours to keep if you don t use them. All the money you pay for insurance premiums in the other plans is gone whether you use the insurance or not.
Health Savings Account Family Deductibles work differently If you enroll your spouse or children; family deductible needs to be met before full benefits take over Contributions into H S A are done monthly so there could be a cash flow issue Large claim in July but $ won t get into account until later in the year.
Health Savings Account Open H.S.A. Checking Account Central Bank Interest Bearing/No Fee Account Annual Contribution Limit $3,350 for Individuals $6,650 for Members with Dependents Don t submit receipts to anybody. You are responsible to make sure you spend the money on appropriate expenses. List of Qualifying Expenses: http://www.jcschools.us/page/10309 Keep receipts for your records in case you are audited
Health Savings Account If you want to put money in your H.S.A. checking account: Can t Contribute to a Medical Flexible Spending Account (FSA). Can still Contribute to Dependent Care FSA Can t have other health insurance coverage.
Plan Choices-3 Choices Employee Cost with Wellness Employee Cost without Wellness H.S.A. BASE BUY-UP $0 + bd pd $20 into Employee s H.S.A. $30/Mo $75/Mo $10/Mo $60/Mo $105/Mo Deductible-Ind $1,500 $1,000 $500 Deductible-Family $3,000 $2,000 $1,000 Co-Insurance 100% $80% 90% MOOP-Ind $3,000 $3,000 $1,500 MOOP-Family $6,000 $6,000 $3,000 Rx Before Deductible is Met Rx After Deductible is Met Rx After Max Out-of- Pocket is met 100% of discounted price Co-Pays Co-Pays Co-Pays Co-Pays Co-Pays 100% Covered Co-Pays Co-Pays
Full Summary of Benefits Base Plan http://jcschools.schoolwires.net/page/140 Buy-Up Plan http://jcschools.schoolwires.net/page/141 HSA Plan http://jcschools.schoolwires.net/page/144
Monthly Employee Contributions Election Base Plan Buy-up Plan H.S.A. W/ Wellness W/out Wellness W/ Wellness W/out Wellness W/ Wellness W/out Wellness Employee-Only $30 $60 $75 $105 0** $10 Emp+Child(ren) $390 $420 $470 $500 $310 $340 Emp+Spouse $560 $590 $650 $680 $460 $490 Emp+Family $920 $950 $1,045 $1,075 $790 $820 ** The board will contribute $20/month into employee s personal H.S.A.
H S A vs. Base Employee Only BASE H S A Employee Only Premium-W/Wellness $360 $360* $ Available in Individual H S A $0 $600** Deductible $1,000 $1,500 Deductible minus $ in H S A $1,000 $540 Co-Insurance after Deductible 20% 0% * Put same employee contribution into H S A account. Actual employee contribution for insurance is $0. ** Board contributes $20/mo. into H S A account
H S A vs. Base Family Plan BASE H S A Family Premium-W/Wellness $11,040 $11,040* $ Available in Individual H S A $0 $1,560** Deductible $2,000 $3,000 Deductible minus $ in H S A $2,000 $1,440 Co-Insurance after Deductible 20% 0% * Put same employee contribution into H S A account. Actual family contribution for HSA plan is $790. ** The difference in annual insurance premium costs.
H S A vs. Buy-up Employee Only Buy-Up H S A Employee Only Premium-W/Wellness $900 $900* $ Available in Individual H S A $0 $1,140** Deductible $500 $1,500 Deductible minus $ in H S A $500 $360 Co-Insurance after Deductible 10% 0% * Put same employee contribution into H S A account. Actual employee contribution for insurance is $0. ** Board contributes $20/mo. into H S A account
H S A vs. Buy-up Family Plan BUY-UP H S A Family Premium-W/Wellness $12,540 $12,540* $ Available in Individual H S A $0 $3,060** Deductible $1,000 $3,000 Deductible minus $ in H S A $1,000 -$60 Co-Insurance after Deductible 10% 0% * Put same employee contribution into H S A account. Actual family contribution for insurance is $790. ** The difference in annual insurance costs.
H S A vs. PPO plans Different Concept Factor Monthly Premiums into Costs Estimate Rx costs and Office Visits How many times do you think you will go to the Dr. x $x per visit What maintenance drugs do you use x discounted price Calculate what costs will be if you are hospitalized Online Decision Calculator: https://www.mywealthcareonline.com/mvphealthcare/resources/hsare sources/whichhsaplanisrightforrme.aspx
Dental / Vision / Optional Life All benefit designs remain exactly the same. All rates remain exactly the same. Open Enrollment for these products also If purchasing additional life insurance you will have to prove Evidence of Insurability.
Flexible Spending Account (FSA) Also know as Cafeteria Plan Annual Election Online Enrollment 2 Different Plans Unreimbursed Medical Only for PPO Plans Use-it-or-Lose-it $500 unused balance rollover feature $2,550 Annual Maximum Dependent Care $5,000 Annual Maximum
District Provided Benefits The Board will continue to provide Long Term Disability 60% of pay after 90 calendar days of disability The benefit is paid tax-free Life Insurance 1 times annual salary Board Health Insurance Contributions $6,000/yr. with wellness $5,640/yr. without wellness
Wellness $30/mo discount on health insurance premiums if the following criteria is met Biometric Health Screening Complete Online Health Risk Assessment Additional opportunities to earn money throughout the year
Other Guardian Worksite Plans Voluntary plans offered through Guardian Short Term Disability Personal Accident Indemnity Cancer Care Critical Illness
Conclusion Complete Online Enrollment by May 18 th Questions Angie Sturm Ext 3014 Ashley Woods Ext 1938 Jason Hoffman Ext 3023 Tonya Berhorst (WallStreet) 636-3255