Transcript informational PowerPoint

New Hire
Benefits
2014
Welcome to KentuckyOne Health
CHI Healthy Spirit Program
• Welcome to CHI/KentuckyOne
Health!
• We want to partner with you and
your family for good health and
financial well-being
• That’s why we created the
Healthy Spirit Program
• Purpose of the program: to
raise the level of the overall wellbeing of CHI employees and their
families
CHI Healthy Spirit Program
How the Healthy Spirit Program can make a difference
in your life:
• Provides you competitive and affordable benefits
• Educates you and your family about what it takes to
build financial security for your life
• Offers comprehensive medical plan options
• Provides tools and resources to help improve fitness
and overall wellness for you and your family
• Supports lower income families by offering the Health
Care Assistance Program
Today’s agenda
Healthy Spirit Program:
 Eligibility
 Review of CHI benefit plans
 Healthy Spirit Wellness Program
 What you need to do
Tip
Watch throughout the
presentation for the tip boxes to
learn more about your CHI
benefits.
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Eligibility
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Eligibility
• You:
o Full-time: regularly scheduled to work 36+ hours per pay period;
or
o Part-time: regularly scheduled to work 20 - 35 hours per pay
period
 Adult dependents:
o Your spouse of the opposite sex who is legally married to you
OR
o Any other adult of the opposite or same sex that is financially
supported by you and lives with you
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Eligibility
 Child dependents:
o Up to age 26
o Includes child dependents of eligible adult dependents
o Physically and mentally handicapped children who are
unmarried and financially dependent on you as long as they
became disabled prior to age 26 and were added and approved
as a disabled dependent on your employer-sponsored health
care plan continuously since reaching age 26
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Dependent Verification
• If you add a dependent to the CHI medical, dental and/or vision
plans, you will receive an audit notice and will be required to provide
documentation.
• Unverified dependents will not be eligible for coverage.
• The audit notice will be sent to your home shortly after you enroll in
your benefits
• The notice will include instructions and a list of options for
supporting documentation
Tip
Be sure to return your dependent
audit notice by the deadline or
else your dependents may not be
eligible for coverage.
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CHI Health Benefits
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CHI Health Benefits
CHI Health Benefits:
 Medical and Prescription
 Healthy Spirit Wellness Program
 Dental
 Vision
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Medical Plan Options
Terms to Know
 Copayment: a flat-dollar amount you are required to pay for a covered service
 Coinsurance: the percentage of the cost that is your responsibility
 Covered Services: services that are covered under the CHI Medical Plan – refer to
the Summary Plan Description for the comprehensive list
 Deductible: the amount you have to pay before the plan begins to pay for a portion of
the costs
 Clinically integrated network: a network within the CHI Medical Plan of health care
providers, facilities and ancillary services collaborating to improve the health of CHI
employees and dependents
 In-Network: refers to a national network of providers within the CHI Medical Plan
 Out-of- Network: refers to providers that are not within the CHI Medical Plan network
 Out-of-Pocket Maximum: the annual maximum amount you will pay for services
through the CHI Medical Plan
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Medical Plan Options
Our Clinically Integrated Network: KentuckyOne Health
Partners
 Clinically integrated networks shift the focus from traditional sick care
to proactive well care
 Supports our focus on improving the health of people and
communities around us
 Our local clinically integrated network, referred to as KentuckyOne
Health Partners, is the preferred network with the highest level of
benefits in the CHI Medical Plan
 If you seek care from a provider within the KentuckyOne Health
Partners, your out-of-pocket costs may be lower
 More importantly your care will be better coordinated through
shared data, better communication, streamlined services,
avoidance of duplicate services, etc.
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Medical Plan Options
Our Clinically Integrated Network: KentuckyOne Health
Partners
•A more holistic approach to your health and wellness through your
primary care physician and other network providers
•Your primary care physician functions as your “primary care medical
home” – a central hub for your medical care
•Whether you have a chronic illness or you are relatively healthy, your
primary care medical home can help you manage your health
 If you enroll in the CHI Medical Plan, you must designate a primary
care physician (PCP)
 Designation must be a family practitioner, pediatrician, an internal
medicine physician or a corresponding mid-level provider (nurse
practitioner or physician assistant) preferably within the local
KentuckyOne Health Partners
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Medical Plan Options
If you enroll in a CHI Medical Plan,
please designate a provider…
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Medical Plan Options
What does the KentuckyOne Health Partners Network do for
you?
 Holistic approach through coordination of more effective, safe
and efficient care
 Encourages you to be more proactive in your own care
 Health information is accessible to any provider within the local
network responsible for your care
 Health benefits, such as: better care results, fewer hospital
admissions for chronic diseases, etc.
 Ensures the right care is provided at the right time
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Medical Plan Options
While on the enrollment website…
See if your doctor is within our local
clinically integrated network.
Tip
You can also search for network
providers through the My Healthy
Spirit website
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Medical Plan Options
Your CHI Medical Plan options:
 Integrated Core
 Integrated Basic
 Integrated High Deductible with Health Savings Account
(HD/HSA)
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Medical Plan Options
Integrated Core
Integrated Basic
Integrated HD/HSA
Annual deductible – the amount you pay before the plan begins to pay benefits
KentuckyOne Health
Partners Network
$1,000 Individual/
$2,000 Family
$2,000 Individual/
$4,000 Family
Anthem Network
$1,000 Individual/
$2,000 Family
$2,000 Individual/
$4,000 Family
Out-of-Network
$2,000 Individual/
$4,000 Family
$4,000 Individual/
$8,000 Family
$2,000 Individual/
$4,000 Family
$4,000 Individual/
$8,000 Family
Office Visits – the amount you pay for covered office visits (preventive care covered 100%)
KentuckyOne Health
Partners Network
Primary Care: $10
Specialist: $25
Primary Care: $20
Specialist: $35
After Deductible:
Primary Care: 15%
Specialist: 20%
Anthem Network
Primary Care: 20%
Specialist: 25%
Primary Care: 30%
Specialist: 35%
After Deductible:
Primary Care: 20%
Specialist: 25%
50% After Deductible
60% After Deductible
60% After Deductible
15% No deductible for Facility
Charges; 10% After deductible for
Physician Charges
15% After deductible
35% After deductible
60% After deductible
25% After deductible
60% After deductible
Out-of-Network
Most Services – the amount you pay for covered services
KentuckyOne Health
Partners Network
Anthem Network
Out-of-Network
10% No deductible for Facility
Charges; 10% After deductible for
Physician Charges
25% After deductible
50% After deductible
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Medical Plan Options
Integrated Core and Integrated Basic Options
 Special feature for these two medical plan options – Health
Reimbursement Account
 Only funded by CHI - $500 for employee only coverage; $1,000 for all
other coverage levels
 Debit card with your health reimbursement funds will be sent from
HealthEquity
 Helps you pay for your eligible health care expenses
 Once the account is depleted, you are responsible for your portion of
any health care expenses
 You cannot contribute to the account
 Unused funds do not roll over into the next plan year
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Medical Plan Options
Integrated High Deductible with Health Savings Account
(HD/HSA)
 Must meet the deductible before the plan begins to pay for medical
AND prescription expenses (preventive medical care is the exception
which is covered at 100%)
 Once deductible is met, you and CHI share in the cost of services
(coinsurance)
 Once out-of-pocket maximum is met, CHI pays 100% for the rest of
the year for covered services – including prescriptions
 Family deductible and works differently than the Integrated Core and
Integrated Basic Plan options – family must meet entire family
deductible before the plan benefits begin
 Similarly the family out-of-pocket maximum must also be met before
plan pays 100 percent
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Medical Plan Options
HD/HSA option includes a health savings account
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Medical Plan Options
Health Savings Account (HSA)
Want to calculate how
much to contribute?
Use the online calculator at
www.healthequity.com/ed/chi
under “Tools & Forms”
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Medical Plan Options
Health Savings Account (HSA)
 Eligibility (per IRS)
 Must be enrolled in a qualified medical plan – such as the
HD/HSA
 Have no other medical coverage – including Medicare or a
spouse’s plan
 You and your family cannot be enrolled in a general health care
flexible spending account, including a spouse’s flexible spending
account – you can enroll in the CHI limited health care flexible
spending account
 You cannot be claimed on someone else’s tax return
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Medical Plan Options
Transferring Your HSA Funds
 You can keep your HSA funds with your current administrator or roll
over your funds to the CHI HSA
 If you enroll in the HD/HSA, your before-tax HSA contributions will go
to the CHI HSA through HealthEquity
 Want to transfer?
 Download Transfer/Rollover Form at www.healthequity.com/form
 Complete the form and submit it to HealthEquity via mail or fax
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Medical Plan Options
Prescription Coverage
Integrated Core
Integrated Basic
Integrated HD/HSA
Retail (30-day supply): CHI/KentuckyOne Health Pharmacy (if available)
Generic
Preferred Brand
Non-preferred Brand
$5
10% ($15 min/$37.50 max)
20% ($25 min/$62.50 max)
$5
15% ($17.50 min/$50 max)
25% ($30 min/$75 max)
After Deductible:
$5
10% ($15 min/$37.50 max)
20% ($25 min/$62.50 max)
$10
20% ($30 min/$75 max)
40% ($50 min/$125 max)
$10
30% ($35 min/$100 max)
50% ($60 min/$150 max)
After Deductible:
$10
20% ($30 min/$75 max)
40% ($50 min/$125 max)
Retail (30-day supply)
Generic
Preferred Brand
Non-preferred Brand
Mail Order (90-day supply): CHI/KentuckyOne Health Mail Order or Retail 90 fill (if available)
Generic
Preferred Brand
Non-preferred Brand
$10
10% ($37.50 min/$62.50 max)
20% ($62.50 min/$125 max)
$10
15% ($42.50 min/$75 max)
25% ($75 min/$150 max)
After Deductible:
$10
10% ($37.50 min/$62.50 max)
20% ($62.50 min/$125 max)
Mail Order (90-day supply)
Generic
Preferred Brand
Non-preferred Brand
$20
20% ($75 min/$125 max)
40% ($125 min/$250 max)
$20
30% ($85 min/$150 max)
25 50% ($150 min/$300 max)
After Deductible:
$20
20% ($75 min/$125 max)
40% ($125 min/$250 max)
Medical Plan Options
Things to Consider: Prescription Coverage
 If you fill a brand-name prescription when a generic equivalent is
available, you will pay:
Brand-name coinsurance + difference between generic
and brand-name amount
 Maintenance medications must be filled using the mail order
pharmacy or a CHI-owned retail pharmacy
 All prescriptions filled from a CHI-owned pharmacy will cost you 50%
less than the copay/coinsurance you will pay for the same drug filled
at a local retail pharmacy
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Medical Plan Options
Contraceptives - Women’s Preventive Health Mandate
 Our prescription drug and health plan administrators are required
to work directly with you if you would like to access these
services and/or prescription drugs at no cost to you:
 Medical services: Patient education and counseling on
contraceptives, administration of certain contraceptives (such as
the insertion of IUD’s or injections) and women’s sterilization
procedures
 Prescription drugs: Generic contraceptives, over-the-counter
contraceptives with a doctor’s prescription and multi-source
brand contraceptives (when a doctor determines it medically
necessary)
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Healthy Spirit Wellness Program
 There is no obligation to participate
 Program is free and confidential
 Available to all employees, even those not enrolled in
the medical plan
 Spouses enrolled in CHI’s Medical Plan can also
participate in the program
 The Healthy Spirit wellness incentive is earned per
quarter
 CHI partners with Preventure to help manage our
wellness program
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Healthy Spirit Wellness Program
Tools available include:
• Personal Health Assessment
• Biometrics screenings
• Health and wellness workshops
• Health coaching
• Disease/condition management
• Variety of trackers and logs
• Activity tracking devices
• Mobile technology
• Fitness club discounts
• Quarterly themed challenges
Tip
Watch the video on My Healthy
Spirit to learn more about the
Healthy Spirit Wellness Program
Helping You Manage Your Health
Condition
For employees who are managing chronic conditions:
 If you have a chronic disease or health condition, your care can be
managed by a “lifestyle coach” and your information will be highly
confidential
 You may be invited to join a disease or chronic condition program
 Free, confidential and voluntary for participants of CHI’s Medical Plan
 Spouses participating in the CHI medical plan also can take
advantage of this program
 Children with asthma or diabetes participating in the CHI Medical
Plan also may participate
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Dental Plan Options
Your CHI Dental Plan options:
 Core
 PPO
CHI Dental Plan is administered by MetLife
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Dental Plan Options
Dental: PPO and Core options
PPO Option
In-network
Out-of-Network
Core Option
In-network
Out-of-network
Deductible
$50 individual/$150 family
$50 individual/$150 family
Annual Max
$1,500
$1,000
Preventive &
Diagnostic
$0
$0
$0
$0
Basic
Restorative
10%
20%
50%
50%
Major
Restorative
40%
50%
50%
50%
Orthodontia
50%, up to $1,500
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50%, up to $1,000
Vision Plan
Vision Plan through EyeMed
EyeMed Select Network Benefit
Exam
$15
Limited to one exam every 12 months
Contact Lens fit & follow-up
Up to $40
Lenses (single, lined bifocal
and lined trifocal)
$15
Limited to once every 12 months
Frames
Contact lenses (allowance
covers materials only)
$120 allowance, plus 20% discount available
Limited to once every 24 months
$105 allowance
Conventional or disposable lenses in lieu of glasses
Limited to once every 12 months
Note: Out-of-network coverage is also available if you see a provider
who is not in the EyeMed Select network.
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CHI Financial Well-being Benefits
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CHI Financial Well-being Benefits
CHI Financial Well-being Benefits:
 Flexible spending accounts
 Disability
 Life insurance
 Retirement savings
 Tuition reimbursement
 Adoption assistance
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Flexible Spending Accounts
Flexible spending accounts
 A flexible spending account allows you to set aside before-tax money
from your paycheck to pay for eligible health care or dependent care
expenses
 Three types of flexible spending accounts:
 Health care flexible spending account – helps you pay for certain health
care expenses, such as deductibles or prescriptions. You cannot enroll in
this type of flexible spending account if you enroll in the HD/HSA medical
plan option.
 Limited purpose post-deductible health care flexible spending account –
if you enroll in the HD/HSA medical plan option, you can contribute to this
limited account for eligible dental and vision expenses. Once your HD/HSA
deductible is met, you can use the account to reimburse yourself for
eligible medical, dental or vision expenses paid out of pocket.
 Dependent care flexible spending account – helps you pay for certain
dependent care expenses, such as daycare.
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Flexible Spending Accounts
Using your health care flexible
spending account debit card
 You will receive a debit card from
HealthEquity when you enroll
 The debit card allows you to purchase
eligible health care items without paying
out of pocket
 The card is loaded with the total available
balance from your health care flexible
spending account selection
 The card comes with instructions on
how to use it
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Flexible Spending Accounts
Things to Consider: Flexible Spending Accounts
 You can use your 2014 flexible spending account funds for expenses
incurred through March 15, 2015
 Expenses must be submitted to HealthEquity by March 31, 2015
 Learn more about the flexible spending accounts at
www.healthequity.com/ed/chi
 General flexible spending accounts overview
 List of eligible expenses
 Flexible spending accounts tax savings worksheet
 If you enroll in a flexible spending account, you can
check your flexible spending account balance and submit for
reimbursement through the HealthEquity website or mobile
application
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Disability Insurance
Automatically enrolled in short-term disability
 Benefits begin after a 7-day elimination period – must use paid
time off
 Provides 80% of your base pay for 5 weeks after the 7-day
elimination period and then provides 60% for remaining 20
weeks, if approved
•If eligible for long-term disability:
• Available for full-time employees
• Provides 60% of your base pay if you are disabled beyond 26
weeks
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Life Insurance
 Will be automatically enrolled in:
 Basic life and AD&D – two times base pay
 Business travel accident – three times base pay
 Have the option to enroll in:
 Supplemental life for you – up to five times base pay (up to a
combined maximum with basic life of $750,000)
 Supplemental life for your spouse – up to $200,000
 Supplemental life for your children – up to $20,000 per child
 Evidence of insurability may be required
 For you: amounts over three times base pay or $500,000
whichever is less
 For your spouse: amounts over $50,000
• Remember to designate your beneficiary
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Retirement Plans
CHI 401(k) Retirement Savings Plan
•You can make pre-tax and Roth after-tax contributions, up to IRS
maximum
•If you do not elect a contribution rate, you will be automatically
enrolled in the plan at a 4 percent pre-tax contribution rate
•CHI will match your contribution 100% on the first 1% + 50% on the
next 5% of eligible pay. If you contribute at least 6% of eligible pay, that
means CHI will provide a maximum rate of match of 3.5% of pay
o You are eligible for the match the first pay period after you have
been paid for 1,000 hours
•You can choose to opt out of the plan, increase or decrease your
contributions at any time
Tip
You can learn more about the
CHI 401(k) Retirement Savings
Plan by watching the retirement
video on My Healthy Spirit
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website
Retirement Plans
• CHI may also make an annual employer contribution of 2.5%* of
eligible pay ($1,000 minimum) to your 401(k) plan account
regardless if you contribute any of your pay if:
o
You must have been paid for at least 1,000 hours prior to the
end of year; and
o
You must be employed on the last day of the year
o
Contributions will generally be made to your 401(k) plan account
after the close of the year end that you are receiving a credit
• If you save at least 6% of your own pay, CHI would contribute up to
an additional 6% to your 401(k) account
• To become fully vested for both matching contributions and the
annual employer contribution you must have completed three years
of vesting service (1,000 paid hours of service each year)
*Note: Employees of CHI Physician Services (CHIPS) and Mountain Management are not eligible for
annual employer contribution.
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Retirement Plans
• CHI 457(b) Non-qualified Deferred Compensation Plan is available
to certain employees whose base pay rate is equal to or greater
than $115,000 OR who is a Physician status (regardless of pay)
o
Allows for additional employee contributions to be deferred on a
pre-tax basis up to the allowable IRS maximum limit
o
Is subject to the risk of creditors claims should CHI become
insolvent
o
Eligible participant should consider maximizing contributions
under the CHI 401(k) plan
o
Investment options are similar to what is offered under the CHI
401(k) plan with the exception of the Self-Directed Brokerage
Window which cannot be legally offered under this plan
43
Tuition Assistance
• Tuition Assistance
o
Annual reimbursement up to $3,000 for full-time employees and
$1,500 for part-time employees.
o
After the course is completed, you are committed to maintaining
employment with our organization for 12 months from the date
the reimbursement is paid or you will have to repay the total
tuition reimbursement amount.
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Adoption Assistance
• Adoption Assistance
o
Annual reimbursement will be $4,000 for full-time employees and
$2,000 for part-time employees. There is no additional
reimbursements beyond the annual reimbursement listed above.
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Other Benefits
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Employee Assistance Program
• Employee Assistance Program is available to your and your family
free of charge
• The program provides access to confidential, professional counseling
that can make it easier to cope with a variety of personal issues and
life changes
• Program is available 24/7
• ValueOptions is the administrator
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Next Steps
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Next Steps
Things to consider before you enroll:
• Evaluate your needs.
• What benefits and services did you pay for and use this past
year?
• What do you expect to need for the near future?
• Could you use the HD/HSA medical plan option to help save on
taxes and build up savings for medical care you may need over
the longer term?
• Look at your medical and prescription claims history online using your
medical and prescription administrator’s websites. There is also a
medical expense estimator tool available on the enrollment website.
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Next Steps
Things to consider before you enroll:
• If you are interested in possibly selecting the HD/HSA, consider the following:
• Review the HD/HSA plan to make sure you understand how it works
• Visit the HealthEquity website, www.healthequity.com/ed/chi, to
understand how the HSA can be used to build medical savings for the
future expenses
• Determine how much you can afford to save from your paycheck into the
HSA (remember CHI is contributing too!)
• Watch your mail for details about the steps to log in to the enrollment website
• While on the enrollment site, take a moment to enroll in the CHI 401(k) Plan
• Visit the My Healthy Spirit website to learn more about the CHI benefits
available to you, including our benefits video library
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Next Steps
While enrolling… go paperless
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Next Steps
Once you enroll and become eligible for benefits:
• If you enroll in the CHI Medical Plan, be sure to designate your
primary care provider through the My Healthy Spirit website
• Start participating in the Healthy Spirit Wellness Program
• Make sure you have designated beneficiaries for your life insurance
and retirement benefits
• Watch your mail for additional information, such as ID cards
• Check your paycheck to ensure your benefit deductions are accurate
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For More Information...
About your CHI benefits:
 My Healthy Spirit website
 Enrollment website
 Spirit magazine
 My Handbook
 HR/Payroll Connection at 1-888-450-9450
 Your local HR representative
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For More Information...
Benefit
Medical
Aetna
Anthem
Blue Cross Blue Shield of IL
QualCare
QualChoice
Wellmark
Prescription
CVS Caremark
Express Scripts
Dental
MetLife
Vision
EyeMed Vision Care
Flexible Spending Accounts
HealthEquity
Employee Assistance Program
ValueOptions
Life Insurance
Prudential Life Insurance
Short-Disability
UNUM
Long-term Disability
Prudential Life Insurance
Business Travel Accident Insurance
CIGNA
CHI 401(k) Retirement Plan
Fidelity Investments
Web
Phone
www.aetna.com
www.anthem.com
www.bcbsil.com
www.qualcareinc.com
www.qualchoice.com
www.wellmark.com
1-800-346-2862
1-855-600-6841
1-866-776-4244
1-800-992-6613
1-800-235-7111
1-800-432-5586
www.caremark.com
www.express-scripts.com
1-877-232-7925
1-800-987-7833
https://mybenefits.metlife.com
1-888-865-6873
www.eyemedvisioncare.com
1-866-299-1358
www.healthequity.com/ed/chi
1-866-212-4634
www.achievesolutions.net/chi
1-877-679-3819
www.prudential.com
1-866-439-9026
www.unum.com
1-800-858-6843
www.prudential.com
1-866-439-9026
www.CIGNA.com
1-800-238-2125
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www.fidelity.com
1-800-343-0860
Questions
Health Care Assistance Program
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Health Care Assistance Program
Making health care affordable for employees
• Offering assistance is based in the tradition of social justice
• The program supports our commitment to offer affordable health care
to employees within CHI
• Consistent with our highest advocacy priority: access and
coverage for all
• Long before health care reform became such a prominent debate,
CHI began planning for this program because we believe it’s the right
thing to do
• The health of our employees and their families will improve as more
people have access to preventive care and health information
• Healthier employees means stronger work teams and better quality of
life at home and work
57
Health Care Assistance Program
Financial assistance for medical plan out-of-pocket
expenses
• Based on household income, employees may qualify for financial
assistance to help with out-of-pocket costs such as deductibles,
coinsurance for doctor’s visits, prescriptions, etc.
 The program is available annually and the application process
typically occurs in July – watch for more information on My Healthy
Spirit website
 Employees approved to participate in the program will be sent more
information to their mailing address
58
Health Care Assistance Program
Next steps for employees accepted to participate in the
program
• If approved for the Health Care Assistance Program, you will need to
sign up for the Integrated Basic medical plan option, including the
dependents you want to cover to receive assistance
• We will send you details about how to use your financial assistance
to pay for eligible health care expenses
• Expenses will be handled through a health reimbursement account
(HRA), that will work like a flexible spending account, through
HealthEquity
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