Transcript 2011 Open Enrollment Presentation

NORTHERN ARIZONA PUBLIC EMPLOYEES BENEFIT TRUST
Open
Enrollment
May 2 – 31
2011
Plan Year
July 1, 2011 – June 30, 2012
1
What is Open Enrollment?
Open Enrollment is the time to:
 add dependents, including the adult child up to age 26
 drop dependents
 make changes to your current elections
 waive out with proof of other group coverage
 add a domestic partner and his/her eligible dependents
 enroll in the Flexible Spending Account
If you are currently in the FSA, you must re-enroll.
2
ADULT CHILDREN TO AGE 26
Health Care Reform now provides that an adult child up
to age 26 may be enrolled in your medical plan on a pretax deduction basis.
PLEASE NOTE THAT YOU MAY ONLY ENROLL THE
CHILD IN THE MEDICAL PLAN AND FUNDS IN YOUR
FLEXIBLE SPENDING ACCOUNT/HEALTH SAVINGS
ACCOUNT MAY ALSO BE USED FOR EXPENSES FOR
THE ADULT CHILD.
The adult child MAY NOT be enrolled for dental, vision or
life coverage.
3
Arizona State Retirement
RETIREMENT Contribution Rates Effective JULY 1, 2011
 State Legislation Changes Contribution Sharing Rates
from 50/50 to 53% employee/47% employer. Effective
07/01/2011
 Employee Contribution:
 11.2% Retirement + .27% LTD = 11.47%
 Current 10.5% Retirement + .25% LTD = 10.75%
 Employer Contribution:
 9.9% Retirement + .23% LTD = 10.13%
 Current: 10.5% Retirement+ .25% LTD = 10.75%
4
NAPEBT Medical Plans
Blue Cross Blue Shield of Arizona
Group # 19676
NAPEBT Rx Plans
CVS Caremark
Plan Year
July 1, 2011 – June 30, 2012
5
NAPEBT
Northern Arizona Public Employees Benefit Trust
• Coconino County
• City of Flagstaff
• NAIPTA
Northern Arizona Intergovernmental Public Transit Authority
• Coconino Community College
• Housing Authority
• Flagstaff Unified School District
• Accommodation Schools
6
NAPEBT – Trends
NAPEBT Health PremiumTrend versus National Health Premium Trend
$600
Monthly Employee Rate
$500
$400
$300
$200
$100
$0
9596
9697
9798
9899
9900
0001
0102
0203
0304
Plan Year
0405
0506
0607
0708
0809
0910
1011
National
Trend
NAPEBT
National health premium trend data is from the Hay Benefits Reports (Hay Group) adjusted from a calendar year basis to correspond with NAPEBT's fiscal
year. The 2010 trend data was not available from Hay, therefore, the 2009 trend increase percentage was used. For the 2006-2007 plan year the NAPEBT
contribution rates are a blend of the one plan offered (7/1/06-12/31/06) and three plans offered (1/1/07-6/30/07) weighted by enrollment. For the 2008-2009
and 2009-2010 plan years the NAPEBT rates are a blend of all three plans weighted by enrollment.
7
MEDICAL PLAN EFFECTIVE July 1, 2011
In-Network
Buy-Up Plan
Base Plan
HDHP
$500
$1,000
$750
$1,500
$1,250**
$2,500**
PCP Copay – Per visit
$25
$35
80%/20%
Specialist Copay – Per visit
$35
$45
80%/20%
Chiropractic Copay
$35
$45
80%/20%
Urgent Care Copay
$50
$75
80%/20%
Emergency Room Access Fee
$100*
$150*
$100*
Inpatient Hospital Access Fee
$100*
$100*
Does not apply
20% after ded
$3,000
$6,000
20% after ded
$3,000
$6,000
20% after ded
$4,000
$5,000
$5/$35/$55/$105
$5/$35/$55/$105
After ded – 20% or $5
2.5x Copay
2.5x Copay
After ded – 20% or $5
2x Copay
2x Copay
After ded – 20% or $5
$1,000
$2,000
$1,500
$3,000
$1,250**
$2,500**
40% after ded
40% after ded
40% after ded
Calendar Year Deductible: Per person
Per family
Member Coinsurance
Out of Pocket Maximum:
Per person
Per family
Rx Retail Copay
Rx Retail 90 day Copay
Rx Mail Order 90 day Copay (CVS Caremark)
Out-of-Network
Calendar Year Deductible: Per person
Per family
Member Coinsurance
*Access Payment and Deductible applied prior to 80%/20% coinsurance
**The In and Out-of-Network deductibles are combined for HDHP.
8
MEDICAL PLAN EFFECTIVE July 1, 2011
Medical Plan FY12
Buy-Up Plan
Employee
Dependent
Total for Family
Base Plan
Employee
Dependent
Total for Family
HDHP
Employee
Dependent
Total for Family
Previous Rates
07/01/10 – 06/30/11
Original Proposal
9.7% Increase
Including $20
Employee Cost Share
Final Rates
8.1% Increase
Including $20
Employee Cost Share
$ 476.04
$ 736.12
$1,212.16
$ 522.20
$ 807.50
$1,329.70
$ 514.58
$ 795.70
$1,310.28
$ 437.38
$ 676.30
$1,113.68
$ 479.80
$ 741.88
$1,221.68
$ 472.78
$ 731.04
$1,203.82
$ 393.26
$ 608.08
$1,001.34
$ 431.40
$ 667.06
$1,098.46
$ 425.10
$ 657.30
$1,082.40
9
MEDICAL PLAN EFFECTIVE July 1, 2011
Employee Cost Sharing
Approved & Adopted by NAPEBT
• Historically, NAPEBT Employers funded 100% of employee base level
premium
• NAPEBT Employers cannot continue to shoulder full cost
• $20/month of cost passed on to employees – some employers have
absorbed this pass through
July 2011 – June 2012 City of Flagstaff/Housing Authority
waiving cost share
•$20 per employee per month x 21 benefit eligible employees =
$5,040 additional cost to FHA
• $240 per year savings to employee
10
COST INCREASE –MEDICAL PLAN
Plan design will not change. This means:
No changes to deductibles,
No changes to co-payments
No changes to access fees.
Exception: An access fee of $100 per visit
has been added for impatient
hospitalization.
11
MEDICAL PLAN EFFECTIVE July 1, 2011
Medical Plan FY12
Monthly
Premium
FHA Cost
Employee Cost
per Month
Buy-Up Plan - $500 Deductible
Employee
$ 514.58
$ 472.78
$ 41.80
Dependent
$ 795.70
$ 405.78
$ 389.92
$1,310.28
$ 878.56
$ 431.72
Total for Family
Base Plan - $750 Deductible
Employee
$ 472.78
$ 472.78
$ 0.00
Dependent
$ 731.04
$ 405.78
$ 325.26
$ 1,203.82
$ 878.56
$ 325.26
Total for Family
HDHP/HSA - $1,250 Deductible
* $47.68 per month employer contribution to HSA or FSA
$ 472.78
$ -47.68
Employee
$ 425.10
Dependent
$ 657.30
$ 405.78
$ 251.52
$1,082.40
$ 878.56
$ 203.84
Total for Family
(425.10 +$47.68 HSA)
12
MEDICAL PLAN EFFECTIVE July 1, 2011
Employee Premium Holiday
One Month at Last Year’s Rates!
Medical Plan FY12
Buy-Up Plan
Employee
Dependent
Total for Family
Base Plan
Employee
Dependent
Total for Family
HDHP
Employee
Dependent
Total for Family
Savings
Per Paycheck
Savings
For Month
$ 1.57
$ 49.30
$ 50.87
$ 3.14
$ 98.60
$ 101.74
$ 0.00
$ 27.37
$ 20.95
$ 0.00
$ 21.90
$ 54.74
$ 0.00
$33.76
$ 33.76
$ 0.00
$ 67.52
$ 67.52
Total Cost to NAPEBT for Employee Premium Increase Holiday: $ 75,100
13
MEDICAL PLAN EFFECTIVE July 1, 2011
HDHP Employer Contribution
• $47.68 per month ($572.16 per year)
• Health Savings Account if Eligible
• Who is NOT eligible for an HSA?
Individuals entitled to Medicare (eligible & enrolled)
Individuals covered under another non-HDHP
Individuals enrolled in AHCCCS or Medicaid or have used IHS
• Flexible Spending Account if NOT Eligible for HSA
14
MEDICAL PLAN EFFECTIVE July 1, 2011
So what’s the bottom line?
Change in Employee Cost Per Paycheck
Previous
Employee Cost
Per Paycheck
Effective July 1, 2011
Employee Cost
Per Paycheck
Difference
Employee Cost
Per Paycheck
Buy-Up Plan
Employee
Dependent
Total for Family
$ 19.33
$145.66
$164.99
$ 20.90
$194.96
$215.86
$ 1.57
$ 49.30
$ 50.87
Base Plan
Employee
Dependent
$ 0.00
$135.26
$ 0.00
$162.63
$ 0.00
$ 27.37
HDHP
Employee
Dependent
$ 0.00
$92.00
$ 0.00
$125.76
$ 0.00
$ 33.76
Medial Plan FY12
15
MEDICAL PLAN EFFECTIVE July 1, 2011
CVS/Caremark
New Rx Vendor
VERY IMPORTANT !!
Effective July 1, 2011 the Prescription Drug Program will be provided
by CVS Caremark Pharmacy.
NO MORE Rx MAIL SERVICE AVAILABLE THROUGH
WALGREENS
90 day supply through mail order will remain
at 2 times co-pay90 day Rx supply at local
network pharmacies will require a co-pay of
2.5 times. Please visit caremark.com for
participating pharmacies.
16
MEDICAL PLAN EFFECTIVE July 1, 2011
FYI…
Useful Information
 Mayo Clinic in Arizona
- Is an in-network Provider on all plans
- Includes Mayo Clinic and Mayo Clinic Hospital Services
- Identify as member of NAPEBT
 Waivers of Medical Coverage
- Other coverage under a qualified group plan other than
another NAPEBT employer
- Must provide enrollment confirmation
17
MEDICAL PLAN EFFECTIVE July 1, 2011
FYI…
Useful Information
 Deductibles run on calendar year
- January 1st – December 31st
 Dual-spouse Deductible Coordination
- Husband and wife employed by a NAPEBT employer.
- Base and buy-up plans only.
- One spouse must have family coverage.
- Indicate on the Blue Cross enrollment form that your spouse
works for NAPEBT and provide the spouse’s ID number.
 Member ID Cards
- Have available at every appointment!
18
MEDICAL PLAN EFFECTIVE July 1, 2011
Patient Protection and Affordable Care
Act
Healthcare Reform

Pre-existing Condition Restrictions
- Removed for children younger than age 19
- Still applies for adults until 2014

Preventative Services
- No office visit co-pay for recommended screenings, general physicals and vaccinations

Eligible Dependents to Age 26
- Without regard to
- Student Status
- Marital Status
- Financial Dependence
- Only applies to legal child of employee
- Does not extend to the spouse or child(ren) of the adult child
- Applies ONLY to Medical plan and Flexible Spending Accounts
19
Wellness Incentive Program
July 2012 – June 2013
NAPEBT – Self-funded Plan
• Rates driven by claims experience
• Increase of large claims
• Increased frequency of in-patient hospitalization
Improved Health of Employees
• Long-term results
Return on Investment
• Studies show a $4 return for every dollar spent on Wellness programs.
• Lower costs for everyone
20
Wellness Incentive Program
July 2012 – June 2013
$20 Cost Share with Employee
• $20 per month added to employee cost for Base and Buy-Up plans
• $20 decrease to HSA / FSA contribution on HDHP.
Opportunity to Waive $20
• Employee participates in Wellness Program
• Complete Biometric Testing
• Fall 2011 Health Fair
• Jan – May 2012
• Complete MyBluePrint Health Assessment
• www.azblue.com
21
NAPEBT Dental Plans
Delta Dental of Arizona
Group # 1331
Plan Year
July 1, 2011 – June 30, 2012
22
DENTAL PLAN EFFECTIVE JULY 1, 2011
Annual Maximum
Benefit per Person
$2,000
Routine Services
100%
Basic Services
80%
Crowns
60%
Major Services
50%
Orthodontia (Ages 8 –
19)
50%
$1,000 Maximum Lifetime Benefit
Calendar year
Deductible
$50 per person
No Max
Premium:
Individual
Family
Total
$33.16
$55.90
$89.06
FHA Share
Employee Share/Month
$65.72
$23.34
23
DENTAL PLAN EFFECTIVE JULY 1, 2011
So what’s the bottom line?
Change in Employee Cost Per Paycheck
Dental Plan FY12
Employee
Dependent
Total for Family
Previous
Employee Cost
Per Paycheck
Effective
July 1, 2011
Employee Cost
Per Paycheck
Difference
Employee Cost
Per Paycheck
$ 0.00
$ 11.08
$ 11.08
$ 0.00
$ 11.67
$ 11.67
$ 0.00
$ 0.59
$ 0.59
24
NAPEBT Vision Plans
VSP
Group # 12239817
Plan Year
July 1, 2011 – June 30, 2012
25
VISION PLAN EFFECTIVE JULY 1, 2011
Vision Plan FY12
Buy-Up Plan
Eye Exam
Once every 12 months
$15.00 Co-pay
Prescription Lenses
Once every 12 months
$25 Material Co-pay
Lenses and/or Frames
$25 Material Co-pay
Lenses and/or Frames
Frames
Once every 24 months
$120 Allowance
20% off additional cost
Contacts
Instead of Glasses
15% discount off
contact lens exam
$120 allowance for
exam & contacts
26
VISION PLAN EFFECTIVE JULY 1, 2011
Monthly Premium
FHA Cost
Employee Cost
per Month
Employee Cost
per Paycheck
Employee
$ 6.97
$ 6.97
$ 0.00
$ 0.00
Dependent
$ 8.00
$ 4.80
$ 3.20
$ 1.60
Total for Family
$ 14.97
$ 11.77
$ 3.20
$ 1.60
Vision Plan FY12
Buy-Up Plan
FLAGSTAFF HOUSING AUTHORITY ADDITIONAL BENEFIT: Excess Cost
Reimbursement = $150/year for employee and $90/year per dependent.
So what’s the bottom line?
There is no change to employee payroll deductions for vision coverage for
2011-2012.
27
NAPEBT
Life Insurance Plans
Minnesota Life
Policy # 33585
Plan Year
July 1, 2011 – June 30, 2012
28
LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
Basic Term Life & Accidental Death &
Dismemberment Insurance
Coverage equal to Salary
• Provided by FHA at no cost to the employee
• May convert to an individual policy upon separation of employment
29
LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
Voluntary Term Life Insurance
• Employee may increase elected coverage amount by
$10,000 at Open Enrollment without underwriting (up to the
Guaranteed Issue limit of $100,000)
• $100,000 guaranteed issue at original enrollment
• Maximum coverage amount = 5x annual salary up to $500,000
• Insure spouse up to half of employee’s voluntary coverage election
• Insure children @ $10,000
30
LIFE INSURANCE PLAN EFFECTIVE JULY 1, 2011
Voluntary Term Life Insurance
• Rate Change
• % of Increase Varied by Age Bracket
• Child Rate – No Change
Employee – Age 36
Previous Monthly Rate
Effective July 1, 2011
$ 5.60
$ 7.20
$ 19.00
$ 23.00
$ 3.25
$ 4.75
$ 14.40
$ 21.20
$80,000 Coverage
Employee – Age 52
$100,000 Coverage
Spouse – Age 47
$25,000 Coverage
Spouse – Age 59
$40,000 Coverage
31
Flexible Spending Accounts
ASI Flex
Plan Year
July 1, 2011 – June 30, 2012
32
FSA PLAN EFFECTIVE JULY 1, 2011
Flexible Spending Accounts

Reduce Tax Liability – PRETAX

Health Care FSA (HCFSA) – allows you to set aside pre-tax dollars to pay
for eligible health care expenses not covered by insurance or reimbursed
from any other source.
• Limited Purpose Health Care FSA (use with a High Deductible Health Plan
(HDHP) and Health Savings Account (HSA)
(dental, vision and preventive care expenses only)
• General Purpose Health Care FSA (qualified health care expenses)

Dependent Care FSA (DCFSA) – allows you to set aside pre-tax dollars to
pay for eligible day care expenses for children up to the age of 13, disabled
children over age 13, and elder care.
33
FSA PLAN EFFECTIVE JULY 1, 2011
FSA – Medical
• Unreimbursed Medical, Prescription, Dental, & Vision expenses
• Up to $3,000 Per Year
• Debit Card
• Reimbursement by Check or Direct Deposit
• Full Amount Elected Available Immediately
• MUST RE-ENROLL EACH YEAR!
• Use or Lose – Be Conservative!
34
FSA PLAN EFFECTIVE JULY 1, 2011
Ineligible Health Care Expenses
• Cosmetic Expenses
• Rogaine, bleaching of teeth, cosmetic surgery (other than
reconstructive surgery following a mastectomy for cancer)
• Dietary Supplements such as Vitamins
• Personal Use Items
• Health Club Memberships
• Tanning Salon
• Over-the-Counter Medications Unless Prescribed by a Doctor
35
FSA PLAN EFFECTIVE JULY 1, 2011
FSA – Dependent Care
• Up to $5,000 per year
• Reimbursement by Check or Direct Deposit
• Funds Available as Contributed
• MUST RE-ENROLL EACH YEAR!
• Use or Lose – Be Conservative!
36
FSA PLAN EFFECTIVE JULY 1, 2011
Ineligible Dependent Care Expenses
• School Expenses for Children in Kindergarten or Older
• Overnight Camping
• Expenses for a Child Age 13 or older (unless disabled)
• Expenses for Nighttime Babysitting
• Daycare Expenses During an Extended Leave of Absence
• When a Dependent is Providing Child Care
• Expenses Paid to Your Child Under the Age of 19
(even if child is not your dependent)
37
Health Savings Accounts
HealthEquity
Plan Year
July 1, 2011 – June 30, 2012
38
HSA PLAN EFFECTIVE JULY 1, 2010
Health Savings Accounts





Only available with election of HDHP
Reduce Tax Liability – PRETAX deduction from gross pay
Use like flexible spending account for Medical, Prescription, Dental
and Vision
Unspent money rolls over year after year; NOT use it or lose it
Take it with you when you leave or retire
• Pay for COBRA, Medicare or Long Term Care Premiums
• Never pay taxes as long as used for qualified expenses
39
HSA PLAN EFFECTIVE JULY 1, 2010
FYI…
Useful Information
• HealthEquity and Blue Cross Blue Shield of Arizona have created an
integrated Health Savings Account (HSA) solution.
•Your claims information will now be available with your HSA account
information for easier management of claims payment and review.
• When you login to the Blue Cross web site (www.blueaz.com) you
can click on a link to take you to the HealthEquity portal where you
can view your claims, see how much you owe, and process payment
(pay a provider, or yourself) – all from the same website.
40
Open Enrollment 2011
Questions?
41