OPEN ENROLLMENT BENEFITS 2018-2019 AGENDA MEDICAL INSURANCE CHANGE - - PowerPoint PPT Presentation

OPEN ENROLLMENT BENEFITS 2018-2019

• MEDICAL INSURANCE CHANGE TO WCA
• HEALTH REIMBURSEMENT ARRANGEMENT
• WELLNESS PROGRAM
• DELTA DENTAL
• LIFE, STD AND LTD
• NEXT STEPS

AGENDA

HEALTH PLAN RENEWAL

Humana renewal calculation included a 32% increase based

• n claims expense

Sought bids from Network Health, WEA Trust, WCA Group Health Trust, WPS and Anthem WCA offered most competitive pricing with a 19.7% increase from current as well as a great service model and a broad network (UHC Choice Plus) that is a close match to our current network.

WCA-GHT – WISCONSIN COUNTIES ASSOCIATION GROUP HEALTH TRUST

• Insures 80+ Wisconsin school districts including

Cedarburg, Brown Deer, Greendale, etc.

3

(Customer Service)

UMR will provide the customer service and assistance with managing your healthcare. In addition, they will serve as the Third Party Administrator to process health claims incurred by the HUHS employees.

WCA MEDICAL: IN-NETWORK BENEFITS

NO CHANGE TO PLAN DESIGN

4

• Deductible:

$2,000 single / $4,000 family (HRA applies) Deductible period January 1 – December 31

• All expenses apply toward deductible
• Once met, 100% coinsurance
• Out-of-pocket maximum:

$2,000 single / $4,000 family

WCA MEDICAL – CHANGES

5

Deductible credit process The portion of deductible you have met January - June will be credited toward your calendar year WCA deductible. One credit file will be loaded by WCA with your plan effective date on July 1st. A second credit file will be loaded by WCA on September 1st (claims through June need to process before we can get a final credit amount).

WCA MEDICAL – CHANGES

6

Rx changes Every carrier has a different prescription drug management company. WCA uses CVS Caremark (broad network of pharmacies). The cost for your medicine may change. If you have mail order prescriptions established, they will not carry over to the new provider. You need to set them up with CVS Caremark. To avoid unforeseen delays, fill any prescription you have as close to June 30th as possible.

WELLNESS – HUMANA AND WCA

7

Humana’s Go365 will end on June 30th. Please plan to redeem any awards by this date. WCA offers the following incentives for wellness:

• Reimbursement for gym expenses $120 single/ $240

family once per calendar

• Gift card for obtaining annual physical (you and

spouse) $50 once per calendar year

• Free telemedicine visits
• Biometric Screening event available at no cost

HEALTH REIMBURSEMENT ARRANGEMENT NO CHANGES TO PLAN

8

• Administered by Employee Benefits Corporation (EBC),

account established in your name by HUHS

• HRA funds are available to reimburse $1,750 (single)
• r $3,500 (family) of your deductible
• You pay the first $250 single or $500 family

Plan year January 1 – December 31

HEALTH REIMBURSEMENT ARRANGEMENT NO CHANGES TO PLAN

How it works:

• 1. You submit explanation of benefits (EOBs) to Employee

Benefits Corporation via mail, fax, scan/email, www.ebcflex.com

• 2. You will be reimbursed for expenses greater than your

portion of deductible ($250/$500)

• 3. File claims until March 31st (for service Jan-Dec),

unused balance rolls over!

• 4. Rollover balance may be used for out-of-pocket medical,

dental and vision expenses

9

MEDICAL PLAN RATES

Note: employee cost for less than full time is prorated. Please contact HR to determine rate.

10

Coverage Tier Employee Cost per month Single $80.88 Family $183.12

ONE PLAN FOR ALL STAFF

11

• Deductible: $0
• Annual Benefit Max: $1,500
• Preventive Services: 100%
• Basic Services: 100%
• Major Services: 100%
• Orthodontics: 50% up to lifetime max of $1,500

DELTA DENTAL PLAN FINDING A NETWORK DENTIST

12

Dentist directories are available: Online www.deltadentalwi.com Via mobile app By phone 800-236-3712 Dentists are listed with their network affiliation PPO Premier NOTE: You can also go to a non-network dentist

DENTAL PLAN

Coverage

• Maximize the network discount to save $$

– PPO – lower rates for service, no balance billing – Premier – somewhat lower rates for service, no balance billing – Out-of-network – no negotiated rates for service

13

Major Services Cost Plan Pays (up to $1,500) You Pay PPO $900 $900 $0 Premier $1,000 $1,000 $0 Other $1,150 $900 $250

DENTAL PLAN RATES

Note: employee cost for less than full time is prorated. Please contact HR to determine rate.

14

Coverage Tier Employee Cost per month Single $3.08 Family $8.22

LIFE AND DISABILITY INSURANCE

15

No cost to you!

• Life insurance equal to one times annual salary
• Long term disability insurance equal to 90% of monthly pay,

begins after 60 days of disability Voluntary short term disability

• You can purchase short term disability up to 66.66 of weekly salary

in flat weekly benefit amounts

• Benefits begin immediately following injury and 3 days following

illness

• If you are enrolled, the enrollment will continue. If you want to

enroll for the first time, evidence of insurability will be required before the benefit is established.

WHAT YOU NEED TO DO!

16

• 1. Your current enrollment in medical and

dental insurance (single or family) will remain in force unless you change it. Complete a change form and return to Mary Christian by June 6th.

• 2. If you wish to waive medical insurance or

continue to waive medical insurance, complete an enrollment form to indicate waiver and return to Mary Christian by June 6th.

• 3. After July 1st, establish login to umr.com

and caremark.com to engage with your new providers.

QUESTIONS?

17